Impact of gastric pouch volume on postoperative weight loss outcomes: A three years follow-up after laparoscopic sleeve gastrectomy.

Abstract

Background: Weight loss failure following laparoscopic sleeve gastrectomy (LSG) is a main cause of surgical revision,deteriorating patients’ quality of life and causing the resurgence of comorbidities. Weight loss after LSG has a multifactorial mechanism. The residual gastric volume (RGV) seems to have a crucial role. Our study aimed to measure the RGV after LSG and its correlation with postoperative weight loss outcomes.Patients and Methods: The present study was a prospective cohort study conducted on 56 obese patients who underwent LSG. The RGV was measured by multidetector computed tomography at 1-, 12-, and 36-months following surgery and was correlated with weight loss outcomes.Results: LSG achieves sufficient and durable weight loss as well as comorbidity resolution. There was a statisticallysignificant decrease in mean body mass index (BMI) from 50.66 kg/m2 preoperatively to 32.94 kg/m2 3 years afterintervention. The percentage of excess weight loss (% EWL) significantly increased from 16.44% at 1 month to 64.1%at 3 years postoperatively. Also, there was a statistically significant increase in mean RGV from 100.23±18.11 at 1month after surgery to 174.88±18.9 at 1 year which also increased to 292.0±38.26 at 3 years postoperatively. We found anonsignificant correlation between weight loss outcomes and the increased RGV.Conclusion: Dilatation of sleeve pouch appears to be a physiological process, and no correlation was found between thisdilation and postoperative weight loss outcomes after 3 years of LSG. Long-term studies are required to authorize thisresult.