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

Background Laparoscopic sleeve gastrectomy (LSG) is now considered an effective bariatric procedure (American Society for Metabolic and Bariatric Surgery statement). We attempted to assess the size of the gastric fundus remaining after LSG and gastric voiding rate (fast/slow) by radiological upper g...

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Bibliographic Details
Published in:Obesity surgery 2011-07, Vol.21 (7), p.858-863
Main Authors: Pomerri, Fabio, Foletto, Mirto, Allegro, Giorgia, Bernante, Paolo, Prevedello, Luca, Muzzio, Pier Carlo
Format: Article
Language:English
Subjects:
Adult
Body Mass Index
Clinical Research
Contrast Media - administration & dosage
Diatrizoate Meglumine
Female
Gastrectomy - methods
Gastric Fundus - anatomy & histology
Gastric Fundus - diagnostic imaging
Gastric Fundus - physiology
Gastrointestinal surgery
Gastrointestinal Transit
Humans
Laparoscopy
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Obesity
Obesity, Morbid - surgery
Radiography
Retrospective Studies
Surgery
Weight control
Weight Loss
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Summary:Background Laparoscopic sleeve gastrectomy (LSG) is now considered an effective bariatric procedure (American Society for Metabolic and Bariatric Surgery statement). We attempted to assess the size of the gastric fundus remaining after LSG and gastric voiding rate (fast/slow) by radiological upper gastrointestinal series (UGS) with a water-soluble contrast medium (CM). The findings were compared with weight loss data. Methods Seventy-four obese patients underwent LSG. Radiological UGS were used to measure the remaining fundus size in 28 of 74 patients 24–72 h after the procedure, with the aid of Matlab software and a library image processing toolbox (MathWorks®). Sleeve voiding was measured in 57 of 74 patients, based on the patients’ radiological reports. Results The mean volume of the remaining fundus was 17.56 ml (range 1.00–77.03 ml). The mean percent excess BMI loss (%EBL) was 39.5%, 53.7%, and 60.8%, respectively, 3, 6, and 12 months after LSG. Sleeve voiding was fast in 49 of 57 patients (85.96%) and slow in eight (14.03%). Conclusions 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.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-010-0255-3