Evaluation of the Radiological Gastric Capacity and Evolution of the BMI 2–3 Years After Sleeve Gastrectomy

Abstract

Gastric capacity can increase late after sleeve gastrectomy even after performing a narrow gastric tubulization. It is very important to measure objectively residual gastric volume after sleeve gastrectomy and its eventual increase in order to determine the late clinical results and to indicate eventual strategy for retreatment.

Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration

“…This initial volume is in accordance with a volume of 116 ml after LSG that has been reported by also using a 32-Fr calibration tube [7]. In another study, a slightly higher volume of 135 ml was found by means of saline instillation and manometric measurements after LSG with a calibration size of 50 Fr [12].…”

“…The estimation of the sleeve stomach volume from upper gastrointestinal series was attempted but abandoned in one study due to the technical challenges and lack of correlation with direct intraoperative measurements [12]. Successful volumetric assessment after LSG by MSCT has been reported by two studies, with a marked dilation of the sleeve being found in an intraindividual comparison of 15 patients during follow-up [7,8].…”

“…For other procedures like gastric banding or gastric bypass, the size of the pouch and its possible dilation are deemed predictors of weight loss and a possible source of complications. Correspondingly, the sleeve size after LSG and its implications are now being controversially discussed [6][7][8][9][10]. An initial volume of 100 ml for the remaining stomach has been suggested as adequate [9,11,12], but considerable dilation during follow-up is not an uncommon finding.…”

“…It is, however, still unclear whether sleeve dilation is a physiological process or represents a cause of insufficient weight loss or secondary weight regain. Dilation is not necessarily linked with weight regain in all patients [7]. A contributory effect of sleeve volume, however, has been postulated, as patients who experience weight regain after LSG often present with disproportionately dilated sleeves [10,13].…”

Reganancia de peso después de la cirugía bariátrica

“…En el seguimiento de pacientes con manga gástri-ca, Braghetto y cols, ha descrito que con el paso del tiempo existe importante aumento de la capacidad de la manga, evaluando con técnicas radiológicas e isotópicas. Al comparar imágenes postoperatorias precoces de la capacidad de la manga calibrada con bujías 32, con imágenes del mismo paciente tomadas años después, se ha encontrado una capacidad del tubo gástrico significativamente mayor 13 . Los aspectos hormonales también han sido considerados.…”