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Obesity Surgery
Published in: Obesity Surgery 5/2021

01-05-2021 | Obesity | Original Contributions

Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy

Authors: Martin Gaillard, Antonio Esposito, Panagiotis Lainas, Pauline Cerbelaud, Cosmin Sebastian Voican, Rodi Courie, Pierre Chague, Gabriel Perlemuter, Laurence Rocher, Ibrahim Dagher, Hadrien Tranchart

Published in: Obesity Surgery | Issue 5/2021

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Abstract

Purpose

Sleeve gastrectomy (SG) has become the most frequent bariatric procedure and staple-line leak represents its most feared complication. Visceral obesity, a core component of the metabolic syndrome, has been associated with worst postoperative outcomes after various abdominal surgical procedures, and can be estimated by computed tomography (CT). The aim of this study was to assess the impact of radiologically determined visceral obesity in the risk of staple-line leak after SG.

Material and Methods

A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG. Several anthropometric variables were measured on a preoperative CT scan. Multivariate analysis was performed to determine preoperative risk factors for staple-line leak.

Results

During the study period, 377 patients were included in the analysis. The median BMI was 39.7 kg/m2 (36.5–43.5) and 8 patients (2.1%) presented a gastric leak. After multivariate analysis, visceral obesity defined by visceral fat area (VFA)/body surface area (BSA) ≥ 85 cm2/m2 was the only independent predictive factor for gastric leak (OR = 5312).

Conclusion

CT scan–assessed visceral obesity defined by a VFA/BSA ratio ≥ 85 cm2/m2 is associated with an increased risk of gastric leak after SG. Preoperatively radiological examination in patients suspected of visceral obesity would be useful to optimize preoperative management.
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Metadata
Title
Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy
Authors
Martin Gaillard
Antonio Esposito
Panagiotis Lainas
Pauline Cerbelaud
Cosmin Sebastian Voican
Rodi Courie
Pierre Chague
Gabriel Perlemuter
Laurence Rocher
Ibrahim Dagher
Hadrien Tranchart
Publication date
01-05-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05199-4

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