Salamat et al. have made an interesting contribution to the expanding literature on
sleeve gastrectomy (SG) outcomes with their paper on the significance of relatively
excessive retained fundus seen on imaging after surgery. While acknowledging that
weight loss is only one of many indicators of success after metabolic and bariatric
operations, the authors focus on weight loss as their primary outcome in this publication.
They also make the accurate point that while an upper gastrointestinal swallow study
is frequently used in the workup of weight regain after weight loss surgery, there
is often no immediate postoperative study for comparison. Therefore, if a Roux-en-Y
gastric bypass (RYGB) patient who is regaining weight is found to have an “expanded
pouch,” nothing is known about the patients who have not regained weight and whether
they, too, may have an expanded pouch.
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References
- Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases.Ann Surg. 2013; 257: 231-237
- Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass.Surg Endosc. 2015; 29: 1484-1491
- Weight loss at three months predicts success at one year after sleeve gastrectomy.Surg Obes Relat Dis. 2015; 11: S194
- The role of hormonal factors in weight loss and recidivism after bariatric surgery.Gastroenterol Res Pract. 2013; 2013: 528450
- The metabolic effects of laparoscopic sleeve gastrectomy: a review.J Minim Invasive Surg Sci. 2013; 2: 3-7
Article info
Publication history
Published online: March 30, 2017
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© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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- Is a “retained fundus” seen on postoperative upper gastrointestinal series after laparoscopic sleeve gastrectomy predictive of inferior weight loss?Surgery for Obesity and Related DiseasesVol. 13Issue 7
- PreviewPostoperative upper gastrointestinal series (UGI) has never been shown to be effective in ruling out leaks or obstruction after gastric bypass or sleeve gastrectomy. In sleeve gastrectomies, UGI will define the shape of the sleeve and rule out a retained fundus that was not optimally excised during surgery.
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