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Impact of 3D-CT-Based Gastric Wall Volume on Weight Loss after Laparoscopic Sleeve Gastrectomy

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Abstract

Purpose

There are several debates on the association between gastric anatomy and weight loss after laparoscopic sleeve gastrectomy (LSG). There is a paucity of data on the impact of gastric wall volume (GWV) on weight loss. This study therefore aimed to investigate the effect of GWV on weight loss response after LSG.

Materials and Methods

Thirty-two patients with body mass index (BMI) of ≧ 40 kg/m2 who underwent LSG between November 2016 and August 2018 were enrolled. Three-dimensional computed tomography (3D-CT) was performed pre-operatively and 1 year after LSG to assess gastric volumes. The population was divided into two groups: the first 20% (n = 7) with the largest GWV, defined as LGWV group, and the rest of the population (n = 25), defined as the small GWV (SGWV) group. Percentage total weight loss (%TWL) was compared.

Results

The mean preoperative GWV was 216.9 ± 47.7 ml in the SGWV group, versus 336.3 ± 24.1 ml in the LGWV group. Patients with LGWV had significantly lower 1-year %TWL (34.9.1% versus 27.9%, p = 0.0439). Multilinear regression identified LGWV as a significant prognostic factor after adjusting for BMI and early weight loss response. Repeated measure mixed effect model showed that the LGWV group had a significantly slower %TWL change, particularly after 3 months postoperatively. No association was found between 1-year %TWL and preoperative and postoperative gastric luminal volume or resected gastric volume.

Conclusion

3D-CT disclosed GWV, but not other gastric anatomical characteristics, was an independent predictor of %TWL after 1-year post LSG.

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Funding

This project was supported in part by the grants from National Taiwan University Hospital (NTUH 104-A128 and 106-A137).

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Author notes

  1. Chih-Horng Wu and Po-Jen Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan

    Chih-Hao Lin, Po-Chu Lee, Chiung-Nien Chen, Ming-Tsan Lin & Po-Jen Yang

  2. Department of Surgery, Sinwu Branch, Tao Yuan General Hospital, Ministry of Health and Welfare, Tao Yuan, Taiwan

    Chih-Hao Lin

  3. Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

    Yu Hsu & Chih-Horng Wu

  4. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Chi-Ling Chen, Wei-Shiung Yang & Chih-Horng Wu

  5. Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan

    Wei-Shiung Yang, Po-Chu Lee, Chiung-Nien Chen & Po-Jen Yang

  6. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Wei-Shiung Yang

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  1. Chih-Hao Lin
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Correspondence to Po-Jen Yang.

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Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Lin, CH., Hsu, Y., Chen, CL. et al. Impact of 3D-CT-Based Gastric Wall Volume on Weight Loss after Laparoscopic Sleeve Gastrectomy. OBES SURG 30, 4226–4233 (2020). https://doi.org/10.1007/s11695-020-04783-y

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