Preoperative Transabdominal Ultrasonography (US) Prior to Laparoscopic Roux-en-Y Gastric Bypass (LRYGBP) and Laparoscopic Sleeve Gastrectomy (LSG) in the First 100 Operations. Was It Beneficial and Reliable During the Learning Curve?

Jaser, Nabil; Mustonen, Harri; Pietilä, J; Juuti, Anne; Leivonen, Marja

doi:10.1007/s11695-011-0416-z

Cited by 9 publications

(5 citation statements)

References 36 publications

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“…[ 32 , 33 ] Standard abdominal ultrasound is characterized by low sensitivity and specificity in detecting a steatohepatitis. [ 34 – 36 ] Thus, in our study, we have observed concentrations of AST and ALT in the blood. In every step of the study the liver enzymes were between laboratory reference range values.…”

Section: Discussionmentioning

confidence: 49%

Different surgical approaches in laparoscopic sleeve gastrectomy and their influence on metabolic syndrome

Hr¹,

Olszewska²,

Czerniawski³

et al. 2018

Medicine

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Obesity is a growing health, social, and economic issue and became an epidemic, according to recent report of World Health Organization.The only method with scientifically proved efficiency of body mass loss is a surgical treatment. Laparoscopic sleeve gastrectomy (LSG) is recently a leading method in metabolic surgery. There are no standards of operative technique for LSG so far. The influence of technique modification on metabolic effect has not been described clearly.The aim of this study was to evaluate metabolic effects in patients with morbid obesity who underwent various surgical approaches of LSG.The study included 120 patients who were randomly divided into 3 groups: Group I, where bougie size was 32 French (Fr), Group II—36 Fr and Group III—40 Fr. Each group was divided into 2 subgroups, based on the distance of resection beginning from the pylorus—2 or 6 cm. Statistical analysis of: body mass index (BMI), the Percentage of Excess Weight Loss (%EWL), the Percentage of Excess BMI Loss (%EBMIL), levels of glucose and insulin on an empty stomach, glycated hemoglobin (HbA1c), insulin resistance (Homeostatic Model Assessment of Insulin Resistance Index—HOMA-IR), aspartate transaminase (AST), alanine transaminase (ALT), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and C-reactive protein (CRP) were under investigation.Statistically significant decrease in body mass, BMI, %EWL, %EBL, glucose, and insulin concentrations has been observed in all studied groups. It was the highest when the smallest calibration tube has been used (32 Fr). Similar results were observed in HOMA-IR and HbA1c levels. Statistically significant decrease of total cholesterol, LDL, and TG concentrations have been observed. Significant increase of HDL in every group has been also noted. Postoperative CRP values were the lowest when the smallest bougie was used.LSG is effective method of obesity treatment. Metabolic effects of LSG are the most noticeable when a small bougie size is used.

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Section: Discussionmentioning

confidence: 49%

Different surgical approaches in laparoscopic sleeve gastrectomy and their influence on metabolic syndrome

Hr¹,

Olszewska²,

Czerniawski³

et al. 2018

Medicine

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“…In the past, Fris [3] and Jaser et al [7] in their respective studies have described techniques for left liver lobe measurement on ultrasound performed in obese patients. These studies reveal two different techniques; one study measured the factor of the volume of left lobe of liver [3].…”

Section: Discussionmentioning

confidence: 99%

“…These studies reveal two different techniques; one study measured the factor of the volume of left lobe of liver [3]. The other study considered the left lobe of liver to be enlarged if there was rounding of the liver border along with the largest sagittal diameter of the left lobe of the liver in the plane of abdominal aorta measuring over 12-cm OR extension of the left border of the liver by over 8 cm from midline at the plane of pancreas and the AP measure of the left lobe of the liver in the plane of abdominal aorta being over 8 cm [7].…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have been conducted worldwide for assessing the usefulness of preoperative ultrasound examination in bariatric patients. The few studies which have been published till date on ultrasound in bariatric patients have included either subjective left lobe measurement or liver length which is generally of the right liver lobe or left liver lobe volume [3,7]. No defined anatomical landmark in the liver has been used to enhance reproducibility of left liver lobe measurements on ultrasound.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of Preoperative Trans-Abdominal Ultrasound Prior to Bariatric Surgery

Nagarajan

Gupta

Nasta

et al. 2020

SN Compr. Clin. Med.

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An enlarged left lobe of liver can complicate bariatric surgery. Preoperative ultrasound of the abdomen is routinely performed in bariatric patients to measure the liver, particularly the left lobe, as well as to record any ancillary findings such as gallstones. Our study aims to evaluate the reliability of ultrasound in evaluating the craniocaudal length of the left lobe of the liver visa -vis intraoperative measurements. It also aims to assess the impact of ancillary findings detected on ultrasound, on the pre-surgical preparation and followup of such patients. Forty patients who were to undergo bariatric surgery in our hospital between June 2018 and May 2019 were included in this study. All of these patients underwent preoperative ultrasound. The measurements of the left lobe of liver evaluated on ultrasound were compared with the intraoperative measurements. Mean preoperative BMI for the forty patients was 41.47 kg/m 2. On applying the paired t test, the left liver lobe measurements calculated by our ultrasound technique correlated with intraoperative measurements. The left liver lobe length measured less than 15 cm in all 40 patients. Ultrasound detected ancillary findings in 8 (20%) patients. Ultrasound showed fatty infiltration of liver in approximately 80% of the patients with a trend towards increasing incidence of fatty change with increasing BMI. Our study showed that left liver lobe measurements calculated by preoperative ultrasound correlate with intraoperative measurements. Ancillary ultrasound findings helped the surgeon in preparing for the bariatric surgery and may modify the follow-up protocol in such patients.

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“…Research has shown that even in 60% of patients, obesity is connected with steatosis, including 55% of the pediatric population [27][28][29][30]. Despite routine abdominal ultrasonography, which according to different authors has low sensitivity and specificity in recognition of liver steatosis, measures of aminotransferases activity have been performed in all patients [31].…”

Section: Discussionmentioning

confidence: 99%

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

Groth

Woźniewska

Olszewska

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: Laparoscopic sleeve gastrectomy (LSG) is recently a leading method in surgical treatment of morbid obesity. The metabolic outcome of intervention may be a result of many factors such as age, gender, preoperative weight loss and dietary restrictions. Aim: To evaluate gender-related differences in the results of LSG in 6-month follow-up. Material and methods: The study included 101 patients who underwent LSG at the University Clinical Hospital of Bialystok. Patients were divided and analyzed in 2 groups: males (n = 48) and females (n = 53). The primary analysis included the influence of gender on postoperative weight loss calculated using the percentage of excess weight loss (%EWL) and excess BMI loss (%EBMIL). For secondary outcomes the levels of glucose, insulin, glycated hemoglobin, aspartate transaminase, alanine transaminase, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides and C-reactive protein were analyzed. Results: A significant influence of patients' gender was proved for both %EWL (p = 0.026) and %EBMIL (p = 0.001). Females had significantly higher %EWL in 6-month follow-up than males (p = 0.0034). The analysis also showed significantly higher %EBMIL for women at 3 and 6 months observation (p = 0.022 and p < 0.001 respectively). Conclusions: Laparoscopic sleeve gastrectomy is an effective method of obesity treatment especially in terms of postoperative weight loss. Females seem to benefit more from the procedure when analyzing the parameters of body mass reduction. However, further research is needed to provide strong evidence of an association between gender and the results of LSG.

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Preoperative Transabdominal Ultrasonography (US) Prior to Laparoscopic Roux-en-Y Gastric Bypass (LRYGBP) and Laparoscopic Sleeve Gastrectomy (LSG) in the First 100 Operations. Was It Beneficial and Reliable During the Learning Curve?

Abstract: Preoperative US is unreliable in evaluating the size and consistency of the left lobe of the liver prior to LRYGBP and LSG and has limited prognostic value for surgical complications and complexity of surgery.

Cited by 9 publications

References 36 publications

Different surgical approaches in laparoscopic sleeve gastrectomy and their influence on metabolic syndrome

Different surgical approaches in laparoscopic sleeve gastrectomy and their influence on metabolic syndrome

Usefulness of Preoperative Trans-Abdominal Ultrasound Prior to Bariatric Surgery

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

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