Role of CT volumetry following gastricplication surgery in morbid obesity:Initial experience in correlatingpostoperative gastric pouch volumewith clinical weight loss

Abstract

Background: Laparoscopic greater curve gastric plication (LGCP) surgery recently emerged as a new bariatric procedure, currently marketed for weight reduction especially in poor developing countries. Objective: The objective of this pilot study was to present initial results of correlation between CT volumetric variations in the residual gastric pouch following LGCP with weight loss in morbidly obese Egyptian patients over a one-year follow-up period. Patients & methods: Forty morbidly obese females (mean age 33.8 +/- 9.1) underwent LGCP. Abdominal multi-slice computed tomography (MSCT) was done, immediately after oral administration of effervescent granules at 1 & 12 months postoperatively. Gastric pouch volumes were measured on 3-dimensional (3-D) masks and correlated with weight loss. Results: All surgeries were performed safely with significant decrease in the mean weight at 1 year follow-up relative to mean pre-operative weight (p=0.0010) and 1 month post-operative weight (p=0.0091). CT evaluation of gastric volumes following LGCP was successful in all cases. The mean CT volume of the gastric pouch at 1 year followup showed significant increase relative to mean volume at 1 month post-operative (p=0.0024). After 1 year, a non significant weak negative correlation was found between the percentage of gastric pouch volume increase and the percentage of weight loss (r=-0.0656, p=0.86). Conclusion: LGCP is safe and successful in achieving significant weight loss in obese Egyptian patients at a low cost. 3-D MSCT volumetry allows non-invasive, important anatomical evaluation, helpful in the postoperative follow-up. Further evaluations with greater samples and longer follow-up will help confirm clinical relevance.