Laparoscopic Sleeve Gastrectomy—Radiological Assessment of Fundus Size and Sleeve Voiding

Abstract

No correlation was found between the estimated volume of the remaining gastric fundus and weight loss (%EBL) after LSG. Patients showing a rapid gastroduodenal transit of the CM achieved a better weight loss than patients with a slow voiding rate.

Early post-operative weight loss after laparoscopic sleeve gastrectomy correlates with the volume of the excised stomach and not with that of the sleeve! Preliminary data from a multi-detector computed tomography-based study

“…Similar results were observed by Vidal et al in their study, where they measured the sleeve volume with upper gastro-intestinal series [8]. Pomerri et al measured the gastric fundus volume and found no correlation between the fundus volume and weight loss achieved up to 1 year postoperatively [11].…”

“…There are hardly any studies evaluating pre-operative stomach volume and volume of stomach excised during LSG. Pomerri et al found no correlation between the volume of the residual fundus and percentage excess weight loss [11].…”

Relationship between gastric pouch and weight loss after laparoscopic sleeve gastrectomy

“…2, 3), is needed. Some studies reported that this might cause a reduced weight loss or weight regain [3]. Our results, along with some others, did not confirm these findings [24,33], showing that the presence of a fundic pouch did not significantly affect weight loss, and, if present, pouch volume was not correlated with BMI reduction.…”

“…Current surgical approaches include restrictive, malabsorptive or combined restrictive/malabsorptive procedures [3]. Laparoscopic sleeve gastrectomy (LSG) was initially discovered as first-step surgery prior to a more complex procedure (Roux-en-Y gastric bypass or biliopancreatic diversion-duodenal switch [4]) to reduce the overall operative risk in super-obese or high-risk patients [5][6][7].…”

Randomized Clinical Trial of Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Management of Patients with BMI < 50 kg/m2

“…This is also true after LSG where ghrelin levels are even lower due to complete extraction of gastric fundus [24,43]. Finally, while LRYGB is known to induce dumping syndrome due to accelerated transit of undigested chime through the GI tract, accelerated gastric emptying can also occur after LSG [28,35,44], which may add to weight loss mechanisms.…”