Radiographic Measurement of Gastric Remnant Volume After Laparoscopic Sleeve Gastrectomy: Assessment of Reproducibility and Correlation with Weight Loss

Abstract

Background As a restrictive procedure, laparoscopic sleeve gastrectomy (LSG) relies primarily on the reduction of gastric volume. It has been suggested that an immediate postoperative gastric remnant volume (GRV) may influence long-term results of LSG; however, there are no consensus in this matter. The aim of this study was to assess the reproducibility of different radiographic methods of GRV calculation and evaluate their correlation with the weight loss (WL) after surgery. Methods This retrospective study evaluated 174 patients who underwent LSG in the period from 2014 to 2017. Using UGI, GRV was measured with 3 different mathematical methods by 2 radiologists. Intraobserver and interobserver calculations were made. Correlation between GRV and WL were estimated with calculations percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL) after 1, 3, 6, 12, 18, and 24 months postoperatively. Results During analysis of intraobserver similarities, the results of ICC calculation showed that reproducibility was good to excellent for all GRV calculation methods. The intraobserver reproducibility for Reader I was highest for cylinder and truncated cone formula and for Reader II for ellipsoid formula. The interobserver reproducibility was highest for ellipsoid formula. Regarding correlation between GRV and WL, significant negative correlation has been shown on the 12th month after LSG in %TWL and %EWL for every method of GRV calculation, most important for ellipsoid formula (%TWL – r(X,Y) = -0.335, p < 0.001 and %EWL – r(X,Y) = -0.373, p < 0.001). Conclusion Radiographic methods of GRV calculation are characterized by good reproducibility and correlate with the postoperative WL. Graphical Abstract

What does the volume of stomach resected during Laparoscopic Sleeve Gastrectomy depend on and what impact does it have on postoperative results?

“…Other researchers, similarly to the present study, proved that the volume of the stomach does not influence the results of body mass loss and BMI loss after LSG [17,21]. Some researchers confirm the relationship between the postoperative volume of the stomach with postoperative body mass loss [22,23].…”

Antiallergic Treatment of Bariatric Patients: Potentially Hampered Solubility/Dissolution and Bioavailability of Loratadine, but Not Desloratadine, Post-Bariatric Surgery

“…Importantly, loratadine solubility in the gastric content after bariatric surgery is much lower than the threshold required for the complete dissolution of the drug dose, predicting incomplete dissolution after LSG. This threshold, designated by the red dashed line in Figure , was calculated by dividing the highest single unit dose (10 mg for loratadine and 5 mg for desloratadine) by the estimated volume (50 mL) of the post-LSG gastric fluid. − On the other hand, desloratadine ex vivo solubility post-surgery was still above the threshold required for the complete dissolution of the drug dose, despite the increased pH and smaller stomach volume.…”