Comment on: Is a “retained fundus” seen on postoperative upper gastrointestinal series after laparoscopic sleeve gastrectomy predictive of inferior weight loss?

      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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