Is a “retained fundus” seen on postoperative upper gastrointestinal series after laparoscopic sleeve gastrectomy predictive of inferior weight loss?

Salamat, Arsalan; Afrasiabi, Mohammad; Lutfi, Rami

doi:10.1016/j.soard.2017.01.032

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Additionally, a study on unintentional fundus retention commenting on weight loss after SG also found no difference in patient outcomes [21]. Clinical studies that challenge the role of ghrelin in weight loss are becoming more abundant, with some reporting a negative effect of ghrelin levels in weight loss after gastric bypass [22][23][24]. To the best of our knowledge, ours is the first study reporting 10-year weight loss outcomes on bypass patients with fundus resection.…”

Section: Discussionmentioning

confidence: 73%

Outcomes at 10-Year Follow-Up after Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, and Sleeve Gastrectomy

Verras

Mulita

Pouwels

et al. 2023

JCM

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Introduction: Morbid obesity is a well-defined chronic disease, the incidence of which is constantly rising. Surgical treatment of morbid obesity has produced superior outcomes compared to conventional weight loss measures. Currently, there is a gap in the literature regarding long-term outcomes. Our single-institution, retrospective cohort study aims to evaluate weight loss outcomes, comorbidity reduction, and adverse effects at 10 years following Roux-en-Y Gastric Bypass (RYGB), Biliopancreatic Diversion (BPD), and Sleeve Gastrectomy (SG). Materials and Methods: We included all consecutive patients with 10-year follow-up records operated on within our institution. The comparison was carried out on the average percentage of weight and BMI loss. Nausea and vomiting were evaluated through self-reporting Likert scales. Diabetes resolution and nutritional deficiencies were also evaluated. Results: A total of 490 patients from 1995 up to 2011 were included in our study. Of these, 322 underwent RYGB, 58 underwent long-limb BPD, 34 underwent laparoscopic RYGB with fundus excision, 47 underwent laparoscopic SG, and 29 underwent laparoscopic RYGB as a revision of prior SG. RYGB and BPD were significantly associated with higher percentages of weight loss (37.6% and 37.5%), but were not found to be independent predictors of weight loss. Nausea and vomiting were associated with SG and laparoscopic RYGB with fundus excision, more so than the other operations. No differences were observed regarding diabetes resolution and nutritional deficiencies. Conclusions: Longer follow-up reports are important for the comparison of outcomes between different types of bariatric operations. BPD and RYGB resulted in superior weight loss, with no observed differences in diabetes resolution and adverse outcomes.

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Section: Discussionmentioning

confidence: 73%

Outcomes at 10-Year Follow-Up after Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, and Sleeve Gastrectomy

Verras

Mulita

Pouwels

et al. 2023

JCM

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“…also reported no significant difference in %EWL in patients with or without retained fundus in their study. [ 17 ] This discrepancy, as explained by the authors of that study, could be due to a lack of a truly large fundus. It is also possible that the differences noted in different studies could be due to a lack of standardisation of gastric fundus volume estimation.…”

Section: Discussionmentioning

confidence: 80%

Is there a role for upper gastrointestinal contrast study to predict the outcomes of sleeve gastrectomy? Lessons learnt from a prospective study

et al. 2022

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Context: The importance of upper gastrointestinal (UGI) contrast study following sleeve gastrectomy (SG) is equivocal. It can, however, yield anatomical and functional details, the significance of which mostly remains unknown. Settings and Design: This prospective, single-center study included SG patients between January 2018 and January 2019. Materials and Methods: UGI contrast study was done on post-operative day 1. The findings of the study namely gastroesophageal junction (GEJ) holdup time, presence of fundus, gastroduodenal emptying (GDE) time, and sleeve shape were compared with weight loss, improvement of glycosylated hemoglobin (HbA1c) and gastroesophageal reflux disease (GERD) symptoms at 3, 6, and 12 months follow-up. Results: There were 138 patients with 100% follow-up. Radiological sleeve patterns observed were: tubular (62.3%), superior (16.0%), and inferior (21.7%) pouches. GEJ holdup time had no effect on percentage total weight loss (%TWL) ( P = 0.09) or HbA1c improvement ( P = 0.077). The absence of fundus led to greater %TWL at 6 months ( P = 0.048). GDE time <15 s led to higher %TWL ( P = 0.028) and lower HbA1c ( P = 0.010) at 12 months. Antrum size <2 cm was associated with higher %TWL ( P = 0.022) and lower HbA1c level ( P = 0.047) at 12 months. Vomiting and regurgitation were common with tubular sleeves. Conclusion: UGI contrast study can predict weight loss, HbA1c improvement, and GERD symptoms. The absence of fundus, small antrum, and rapid GDE are associated with better weight loss. HbA1c improvement is better with small antrum and rapid GDE. Tubular sleeve predisposes to vomiting and regurgitation.

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Revisional Surgery for Sleeve Gastrectomy

Binenbaum

Paulin

2019

Revisional Foregut Surgery

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Is a “retained fundus” seen on postoperative upper gastrointestinal series after laparoscopic sleeve gastrectomy predictive of inferior weight loss?

Cited by 5 publications

References 24 publications

Outcomes at 10-Year Follow-Up after Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, and Sleeve Gastrectomy

Outcomes at 10-Year Follow-Up after Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, and Sleeve Gastrectomy

Is there a role for upper gastrointestinal contrast study to predict the outcomes of sleeve gastrectomy? Lessons learnt from a prospective study

Revisional Surgery for Sleeve Gastrectomy

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