title: Relevance of Roux-en-Y gastric bypass volumetry using 3-dimensional gastric computed tomography with gas to predict weight loss at 1 year.
abstract: BACKGROUND
  Causes of Roux-en-Y gastric bypass (RYGB) failures are still controversial. Literature data suggest that gastric pouch or gastrojejunal anastomosis distentions over time could be a key factor. Making the hypothesis that progressive distention of RYGB volumes is 1 of the main factors of weight loss failure, the aim of our study was to evaluate bypass volumes changes using repeated 3-dimensional gastric computed tomography with gas and the possible negative correlation with weight loss results at 1 year.
  
  
  METHODS
  Thirty-nine patients eligible for RYGB were prospectively included. Gastric bypass volumes were assessed at 3 and 12 months postsurgery performing 3-dimensional gastric computed tomography with gas and weight loss outcomes were recorded during the first postoperative year.
  
  
  RESULTS
  There was no loss to follow up. Mean % excess body mass index lost (%EBMIL) at 1 year was 66.7%. Seven patients (17.9%) did not reach Reinhold criteria and were considered as RYGB failures. We found no linear correlation between the 1 year %EBMIL and mean values of the gastric pouch (r=.01; P=.94), and the neo stomach (r=.09 ; P=.57) at 3 months. Revisional surgery was correlated negatively with %EBMIL at 1 year.
  
  
  CONCLUSIONS
  Weight loss at 1 year does not seem to be correlated to RYGB volume changes. Behavioral factors probably play a major role in weight loss failure.
authors.affiliation: Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France; Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France. Electronic address: maud.robert@chu-lyon.fr.
authors.forename: Maud
authors.initials: M
authors.lastname: Robert
authors.affiliation: Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France.
authors.forename: Albane
authors.initials: A
authors.lastname: Pechoux
authors.affiliation: Department of Radiology, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Marion
authors.affiliation: Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Department of Endocrinology, Diabetology and Nutrition, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Laville
authors.affiliation: Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France; Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Gouillat
authors.affiliation: Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Department of Endocrinology, Diabetology and Nutrition, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Disse
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D057234:Preoperative Period; D013270:Stomach / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D015431:Weight Loss
keywords: Gastric computed tomography; Morbid obesity; Roux-en-Y gastric bypass; Volumetry; Weight loss