Correlation of weight loss with residual gastric volume and morphology after sleeve gastrectomy: A CT-Based Analysis

Background Laparoscopic sleeve gastrectomy (LSG) has been accepted as a primary bariatric procedure. The aim of the study was to evaluate the volume and the morphologies of remnant stomachs after LSG and their association with weight loss. Methods Twenty patients who underwent Laparoscopic sleeve gastrectomy (LSG) were followed prospectively and evaluated at 12 months after operation using computed tomography CT with 3D reconstruction to evaluate the shape and volume of the residual stomach after LSG. Total sleeve volume (TSV), tube volume (TV), antral volume (AV) and tube/antral volume ratio (TAVR) were included. Results Mean %EWL (excess weight loss) at 12 months postop was 57 .57 ± 15.82 , The majority of sleeve morphology was tubular sleeve (35%) and mean TSV, TV, AV, and TAVR were 376.39 ± 114.2 cc, 194.81 ± 65.7 cc, 179.09 ± 58.4 cc ,1.48 ± 0.51 respectively. Dumbbell Shaped sleeve was significantly associated with Vomiting and protein intolerance, p= (0.013 ,0.018). No significant association between morphology of sleeve and EWL, p = .07 but tubular sleeve had adequate weight loss. TV and T/A volume were significantly higher among patients who had dumping, p =  0.004, 0.028 respectively. A V was significantly lower in patients with protein intolerance, p = 0.023 . TSV was not correlated significantly with %EWL at 12 months postop (r = 0.1, p = 0.64) but patients with lower TV showed significantly adequate weight loss , p =  0.021 Conclusions Although there is no clear association between sleeve morphology or volume and EWL at 12 months, tubular sleeve and lower TV had adequate weight loss.