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 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.
Pomerri
Fabio
F
Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128, Padua, Italy. fabio.pomerri@unipd.it
Foletto
Mirto
M
Allegro
Giorgia
G
Bernante
Paolo
P
Prevedello
Luca
L
Muzzio
Pier Carlo
PC
D000328:Adult; D015992:Body Mass Index; D003287:Contrast Media / Q000008:administration & dosage; D003974:Diatrizoate Meglumine; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005748:Gastric Fundus / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology; D005772:Gastrointestinal Transit; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D015431:Weight Loss
D003287:Contrast Media; D003974:Diatrizoate Meglumine