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Published in: Obesity Surgery 3/2018

01-03-2018 | Original Contributions

3D Volumetry and its Correlation Between Postoperative Gastric Volume and Excess Weight Loss After Sleeve Gastrectomy

Authors: Andrés Hanssen, Sergio Plotnikov, Geylor Acosta, José Tomas Nuñez, José Haddad, Carmen Rodriguez, Claudia Petrucci, Diego Hanssen, Rafael Hanssen

Published in: Obesity Surgery | Issue 3/2018

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Abstract

Background

The volume of the postoperative gastric remnant is a key factor in excess weight loss (EWL) after sleeve gastrectomy (SG). Traditional methods to estimate gastric volume (GV) after bariatric procedures are often inaccurate; usually conventional biplanar contrast studies are used.

Methods

Thirty patients who underwent SG were followed prospectively and evaluated at 6 months after the surgical procedure, performing 3D CT reconstruction and gastric volumetry, to establish its relationship with EWL. The gastric remnant was distended with effervescent sodium bicarbonate given orally. Helical CT images were acquired and reconstructed; GV was estimated with the software of the CT device. The relationship between GV and EWL was analyzed.

Results

The study allowed estimating the GV in all patients. A dispersion diagram showed an inverse relationship between GV and %EWL. 55.5% of patients with GV ≤ 100 ml had %EWL 25–75% and 38.8% had an %EWL above 75% and patients with GV ≥ 100 ml had an %EWL under 25% (50% of patients) or between 25 and 75% (50% of this group). The Pearson’s correlation coefficient was R = 6.62, with bilateral significance (p ≤ .01). The Chi-square result correlating GV and EWL showed a significance of .005 (p ≤ .01). The 3D reconstructions showed accurately the shape and anatomic details of the gastric remnant.

Conclusions

3D volumetry CT scans accurately estimate GV after SG. A significant relationship between GV and EWL 6 months after SG was established, seeming that GV ≥ 100 ml at 6 months of SG is associated with poor EWL.
Literature
1.
go back to reference Vidal P, Ramón JM, Busto M, et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):359–63.CrossRefPubMed Vidal P, Ramón JM, Busto M, et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):359–63.CrossRefPubMed
2.
3.
go back to reference Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.CrossRefPubMed Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.CrossRefPubMed
4.
go back to reference Boza C, Daroch D, Barros D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1129–33.CrossRefPubMed Boza C, Daroch D, Barros D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1129–33.CrossRefPubMed
5.
go back to reference Sleeve gastrectomy as a bariatric procedure. Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2007;3(6):573–6.CrossRef Sleeve gastrectomy as a bariatric procedure. Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2007;3(6):573–6.CrossRef
6.
go back to reference Golomb I, Ben David M, Glass A, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. JAMA Surg. 2015;150(11):1051–7.CrossRefPubMed Golomb I, Ben David M, Glass A, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. JAMA Surg. 2015;150(11):1051–7.CrossRefPubMed
7.
go back to reference Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17(11):1442–50.CrossRefPubMed Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17(11):1442–50.CrossRefPubMed
8.
go back to reference Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18(5):560–5.CrossRefPubMed Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18(5):560–5.CrossRefPubMed
9.
go back to reference Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.CrossRefPubMed Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.CrossRefPubMed
10.
go back to reference D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed
11.
go back to reference Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.CrossRefPubMed Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.CrossRefPubMed
12.
go back to reference Obeidat FW, Shanti HA, Mismar AA, et al. Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obes Surg. 2014;24(11):1904–8.CrossRefPubMed Obeidat FW, Shanti HA, Mismar AA, et al. Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obes Surg. 2014;24(11):1904–8.CrossRefPubMed
13.
go back to reference Pawanindra L, Vindal A, Midha M, et al. 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. Surg Endosc. 2015;29(10):2921–7.CrossRefPubMed Pawanindra L, Vindal A, Midha M, et al. 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. Surg Endosc. 2015;29(10):2921–7.CrossRefPubMed
14.
go back to reference Robert M, Pasquer A, Pelascini E, et al. Impact of sleeve gastrectomy volumes on weight loss results: a prospective study. Surg Obes Relat Dis. 2016;12(7):1286–91.CrossRefPubMed Robert M, Pasquer A, Pelascini E, et al. Impact of sleeve gastrectomy volumes on weight loss results: a prospective study. Surg Obes Relat Dis. 2016;12(7):1286–91.CrossRefPubMed
15.
go back to reference Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19(11):1515–21.CrossRefPubMed Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19(11):1515–21.CrossRefPubMed
17.
go back to reference Karcz WK, Kuesters S, Marjanovic G, et al. 3D-MSCT gastric pouch volumetry in bariatric surgery-preliminary clinical results. Obes Surg. 2009;19(4):508–16.CrossRefPubMed Karcz WK, Kuesters S, Marjanovic G, et al. 3D-MSCT gastric pouch volumetry in bariatric surgery-preliminary clinical results. Obes Surg. 2009;19(4):508–16.CrossRefPubMed
18.
go back to reference Blanchet MC, Mesmann C, Yanes M, et al. 3D gastric computed tomography as a new imaging in patients with failure or complication after bariatric surgery. Obes Surg. 2010;20(12):1727–33.CrossRefPubMed Blanchet MC, Mesmann C, Yanes M, et al. 3D gastric computed tomography as a new imaging in patients with failure or complication after bariatric surgery. Obes Surg. 2010;20(12):1727–33.CrossRefPubMed
19.
go back to reference Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obes Surg. 2009 Sep;19(9):1262–9.CrossRefPubMed Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obes Surg. 2009 Sep;19(9):1262–9.CrossRefPubMed
20.
go back to reference Baumann T, Grueneberger J, Pache G, et al. Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration. Surg Endosc. 2011;25(7):2323–9.CrossRefPubMed Baumann T, Grueneberger J, Pache G, et al. Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration. Surg Endosc. 2011;25(7):2323–9.CrossRefPubMed
Metadata
Title
3D Volumetry and its Correlation Between Postoperative Gastric Volume and Excess Weight Loss After Sleeve Gastrectomy
Authors
Andrés Hanssen
Sergio Plotnikov
Geylor Acosta
José Tomas Nuñez
José Haddad
Carmen Rodriguez
Claudia Petrucci
Diego Hanssen
Rafael Hanssen
Publication date
01-03-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2927-8

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