Influence of the Resected Gastric Volume on the Weight Loss After Laparoscopic Sleeve Gastrectomy

Overview

Journal Obes Surg

Date 2015 Nov 26

PMID 26602213

Citations 10

Authors

Mohamed Bekheit

Tamer Nabil Abdel-Baki

Mostafa Gamal

Wael Abdel-Salam

Mohamed Samir

ElSaied ElKayal

Khaled Katri

Affiliations

Soon will be listed here.

Abstract

Background: The relation between the resected gastric volume and the weight loss after laparoscopic sleeve gastrectomy appears conflicting in the literature. Both the residual and the resected volumes represent the total gastric volume, and if the weight loss is related to one of the two volumes, it should be related to the other. While some reports indicate that the weight loss is related to the resected gastric volume, others state that the weight loss is not related to the residual volume. The aim is to investigate the influence of the resected gastric volume on the weight loss after surgery.

Methods: The study included 287 consecutive patients. Gastrectomy was performed encroaching over a 38-Fr calibrating tube all the way to the angle of His. Filling volume of the resected stomach, with tap water, was measured. Patients were analyzed into group 1 with BMI ≤50 kg/m(2) and group 2 >50 kg/m(2).

Results: Females represented 74 % of cases. Mean age was 32.9 ± 9.5 years; preoperative BMI = 48.7 ± 7.9 kg/m(2). The mean resected gastric volume was 1525 ± 408 ml, and it was significantly lower in females compared to that in males (1443 ± 311 vs 1824 ± 502 ml, p < 0.001). Data were analyzed in two groups: group 1 with BMI ≤5050 kg/m(2) and group 2 >50 kg/m(2). Both groups were similar in preoperative BMI (p = 0.399) and excess weight percent (EW%) (p = 0.33). Group 2 had a resected gastric volume (1663 ± 424.7 ml) greater than that of group 1 (1440 ± 347 ml; p < 0.001). The percentage of excess weight loss (EWL%) was 57.9 ± 14.5 % at 6 months (62.7 ± 13.5 % vs 48.34 ± 11.29 %, p < 0.001), 77 ± 19 % at 12 months (84 ± 19.6 % vs 68 ± 14.2 %, p = 0.001), 76.6 ± 7.4 % at 18 months (79.7 ± 4.8 vs 74.7 ± 8.2 %, p = 0.5), and 75.8 ± 11.5 % at 24 months (81.7 ± 11.17 vs 70 ± 11 %, p = 0.8) (group 1 vs group 2, respectively). At 12 months, 86 % patients achieved more than 50 % EWL% (100 % of group 1 vs 60 % of group 2). Preoperative BMI correlated with resected gastric volume (r = 0.239, p = 0.004). In multiple regression, the initial BMI was a predictor of EWL% at 6 and 12 months (r partial = -0.65, p < 0.0001) while the resected gastric volume was not.

Conclusions: The resected gastric volume is related to the total gastric volume when the technique is standardized and the residual volume is calibrated using a consistent technique. It is not in itself a predictor of weight loss, but it is related to the initial BMI which predicts the weight loss.

Citing Articles

Development and Evaluation of a Quality Assessment Tool for Laparoscopic Sleeve Gastrectomy Videos: A Review and Comparison of Academic and Online Video Resources.

Alghazawi L, Fadel M, Chen J, Das B, Robb H, Rodriguez-Luna M Obes Surg. 2024; 34(5):1909-1916.

PMID: 38581627 PMC: 11031436. DOI: 10.1007/s11695-024-07199-0.

Radiographic Measurement of Gastric Remnant Volume After Laparoscopic Sleeve Gastrectomy: Assessment of Reproducibility and Correlation with Weight Loss.

Deregowska-Cylke M, Palczewski P, Blaz M, Cylke R, Ziemianski P, Szeszkowski W Obes Surg. 2021; 32(2):230-236.

PMID: 34799810 PMC: 8794890. DOI: 10.1007/s11695-021-05812-0.

Impact of Resection Volume/Stapler Firings-Ratio on Perioperative Complications and Weight Loss After Laparoscopic Sleeve Gastrectomy.

Della Penna A, Lange J, Archid R, Hones F, Konigsrainer A, Quante M Obes Surg. 2020; 31(1):207-214.

PMID: 32728840 PMC: 7808967. DOI: 10.1007/s11695-020-04870-0.

Residual Gastric Volume Relationship and Weight Loss After Laparoscopic Sleeve Gastrectomy.

Dogan S, Onmez A, Cetin M, Ozaydin I, Pehlivan M Obes Surg. 2020; 30(5):1929-1934.

PMID: 31953743 DOI: 10.1007/s11695-020-04417-3.

Impact of Resected Gastric Volume on Postoperative Weight Loss after Laparoscopic Sleeve Gastrectomy.

DUgo S, Bellato V, Bianciardi E, Gentileschi P Gastroenterol Res Pract. 2019; 2019:3742075.

PMID: 31871448 PMC: 6913301. DOI: 10.1155/2019/3742075.

References

Chial H, Camilleri C, Delgado-Aros S, Burton D, Thomforde G, Ferber I . A nutrient drink test to assess maximum tolerated volume and postprandial symptoms: effects of gender, body mass index and age in health. Neurogastroenterol Motil. 2002; 14(3):249-53. DOI: 10.1046/j.1365-2982.2002.00326.x. View

Delgado-Aros S, Cremonini F, Castillo J, Chial H, Burton D, Ferber I . Independent influences of body mass and gastric volumes on satiation in humans. Gastroenterology. 2004; 126(2):432-40. DOI: 10.1053/j.gastro.2003.11.007. View

Bult M, van Dalen T, Muller A . Surgical treatment of obesity. Eur J Endocrinol. 2008; 158(2):135-45. DOI: 10.1530/EJE-07-0145. View

Parikh R, Joshi S, Menon P, Shah N . Index of central obesity - A novel parameter. Med Hypotheses. 2006; 68(6):1272-5. DOI: 10.1016/j.mehy.2006.10.038. View

Bekheit M, Katri K, Ashour M, Sgromo B, Abou-ElNagah G, Abdel-Salam W . Gender influence on long-term weight loss after three bariatric procedures: gastric banding is less effective in males in a retrospective analysis. Surg Endosc. 2014; 28(8):2406-11. DOI: 10.1007/s00464-014-3489-7. View

Yu J . [Bariatric surgery and multidisciplinary treatment for obesity]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2011; 33(3):219-23. DOI: 10.3881/j.issn.1000-503X.2011.03.001. View

Benaiges D, Goday A, Ramon J, Hernandez E, Pera M, Cano J . Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis. 2011; 7(5):575-80. DOI: 10.1016/j.soard.2011.03.002. View

Vidal P, Ramon J, Busto M, Dominguez-Vega G, Goday A, Pera M . Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2013; 24(3):359-63. DOI: 10.1007/s11695-013-1113-x. View

Langer F, Reza Hoda M, Bohdjalian A, Felberbauer F, Zacherl J, Wenzl E . Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005; 15(7):1024-9. DOI: 10.1381/0960892054621125. View

10.

Abeles D, Shikora S . Bariatric surgery: current concepts and future directions. Aesthet Surg J. 2008; 28(1):79-84. DOI: 10.1016/j.asj.2007.09.007. View

11.

Boza C, Gamboa C, Salinas J, Achurra P, Vega A, Perez G . Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: a case-control study and 3 years of follow-up. Surg Obes Relat Dis. 2012; 8(3):243-9. DOI: 10.1016/j.soard.2011.08.023. View

12.

Baraki Y, Traverso P, Elariny H, Fang Y . Preoperative prediction of stomach weight to be removed in laparoscopic sleeve gastrectomy procedure. Surg Technol Int. 2010; 20:167-71. View

13.

Wang S, Brownell K, Wadden T . The influence of the stigma of obesity on overweight individuals. Int J Obes Relat Metab Disord. 2004; 28(10):1333-7. DOI: 10.1038/sj.ijo.0802730. View

14.

Obeidat F, Shanti H, Mismar A, Albsoul N, Al-Qudah M . The Magnitude of Antral Resection in Laparoscopic Sleeve Gastrectomy and its Relationship to Excess Weight Loss. Obes Surg. 2015; 25(10):1928-32. DOI: 10.1007/s11695-015-1642-6. View

15.

Yehoshua R, Eidelman L, Stein M, Fichman S, Mazor A, Chen J . Laparoscopic sleeve gastrectomy--volume and pressure assessment. Obes Surg. 2008; 18(9):1083-8. DOI: 10.1007/s11695-008-9576-x. View

16.

Parikh M, Gagner M, Heacock L, Strain G, Dakin G, Pomp A . Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008; 4(4):528-33. DOI: 10.1016/j.soard.2008.03.245. View

17.

Obeidat F, Shanti H, Mismar A, Elmuhtaseb M, Al-Qudah M . Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obes Surg. 2014; 24(11):1904-8. DOI: 10.1007/s11695-014-1330-y. View

18.

Oviedo G, Pompetti D, Quines M, Roa C, Romero A . [Effect of intragastric balloon as an alternative method for weight loosing in obese patients]. Nutr Hosp. 2009; 24(1):40-5. View

19.

. Epidemic of obesity fuels demand among payers for alternatives to bariatric surgery. Dis Manag Advis. 2003; 9(11):146-9, 141. View

20.

Bohdjalian A, Langer F, Shakeri-Leidenmuhler S, Gfrerer L, Ludvik B, Zacherl J . Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010; 20(5):535-40. DOI: 10.1007/s11695-009-0066-6. View