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Short Term Volumetric Changes of The Stomach Following Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Gastric Plication

This document is a thesis submitted by Aly Fahim A. El Bassiouny to fulfill requirements for a Master's Degree in General Surgery from Cairo University. The thesis compares the short term volumetric changes of the stomach following two restrictive bariatric procedures: laparoscopic sleeve gastrectomy and laparoscopic gastric plication. Computed tomography volumetry was used to measure the residual gastric volume in 15 patients one month after undergoing one of the two procedures. The results were expressed in cubic centimeters and aimed to evaluate which procedure is more effective at reducing stomach volume in the short term.

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DrGeorge Saad Abdalla
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68 views7 pages

Short Term Volumetric Changes of The Stomach Following Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Gastric Plication

This document is a thesis submitted by Aly Fahim A. El Bassiouny to fulfill requirements for a Master's Degree in General Surgery from Cairo University. The thesis compares the short term volumetric changes of the stomach following two restrictive bariatric procedures: laparoscopic sleeve gastrectomy and laparoscopic gastric plication. Computed tomography volumetry was used to measure the residual gastric volume in 15 patients one month after undergoing one of the two procedures. The results were expressed in cubic centimeters and aimed to evaluate which procedure is more effective at reducing stomach volume in the short term.

Uploaded by

DrGeorge Saad Abdalla
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Short term volumetric

changes of the Stomach following


Laparoscopic sleeve gastrectomy versus
Laparoscopic gastric plication
Thesis
Submitted in partial fulfillment of the Master Degree (M.Sc) in
General Surgery
By
Aly Fahim A. El Bassiouny
(M.B., B.Ch.)
Resident of General Surgery
Faculty of Medicine, Cairo University
Under Supervision of
Prof. Dr. Mostafa Lotfy Aboul Nasr
Prof. of General Surgery
Faculty of Medicine
Cairo University
Dr. Omar Abdel Aziz Hamada
Lecturer of Radiology
Faculty of Medicine
Cairo University
Dr. Mohamed Abdul Moneim El Masry
Lecturer of General Surgery
Faculty of Medicine
Cairo University
Faculty of Medicine
Cairo University

2011

Acknowledgement
First and foremost, I feel always indebted to God, the kind and merciful. I
am greatly honored to express my deep respect and gratitude to Prof. Dr.
Mostafa Lotfy Aboul Nasr, the eminent Professor of General Surgery, Cairo
University,

for

his

faithful

supervision,

understanding,

help

and

encouragement in initiating and completing this work.


I am so much obliged to Dr. Omar Abdel Aziz Hamada, Lecturer of
Radiology, Cairo University, for his continuous guidance and valuable
advices throughout this work. I am much grateful for his help and support
throughout all steps of this work.
I am greatly indebted to Dr. Mohamed Abdel Moneim El Masry,
Lecturer of General Surgery, Cairo University, whose constructive ideas,
support, great help, dedication and generous guidance was the cause to
initiate the start of this work and continue its progress to its present state.
I am also obliged to all my professors, my seniors, and my colleagues
for their continuous and endless encouragement in this work.

TABLE OF CONTENTS
Page

Title

1
5
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7
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21
53
62
71
95
100
101

INTRODUCTION AND AIM OF THE WORK


REVIEW OF LITERATURE
- Anatomy of the Stomach
- Physiology of the Stomach
- Diagnostic Tests
- Pathophysiology of Morbid Obesity
- Surgery for Morbid Obesity
- Volumetry of the Stomach
PATIENTS & METHOS
RESULTS
DISCUSSION
CONCLUSION AND SUMMARY
REFERENCES

Abstract :
Morbid Obesity is now a well established problem affecting a considerable
percentage of the population. Bariatric surgery has proven to be the only effective
method in treatment of this condition, with the two options available being
restrictive and malabsorbtive ones. The aim of this study is to compare the residual
gastric volume in two restrictive bariatric procedures, Laparoscopic Sleeve
Gastrectomy (LSG) and Laparoscopic Gastric Plication (LGP).
Computed tomography (CT) volumetry, a recent and non-invasive method
that measures volume of internal organs, was used to assess the residual gastric
volume one month after both procedures in a group of 15 patients. Results were
expressed in cubic centimeters.

Key words :
Bariatric surgery Gastric Laparoscopy Morbid obesity Restrictive Sleeve gastrectomy
Gastric Plication Gastric Volume Weight loss

Abbreviations

BAO: basal acid output.


BMI: body mass index.
BPD: biliopancreatic diversion.
BPD-DS: biliopancreatic diversion with duodenal switch.
CCK: cholecystokinin.
CT: computed tomography.
DGBP: distal gastric bypass.
ECG: Electrocardiogram.
ECL: enterochromaffin-like.
EGD: esophagogastroduodenoscopy.
EGG: electrogastrography.
EMR: endoscopic mucosal resection.
EUS: endoscopic ultrasound.
EWL: excessive weight loss.
GE: gastro-esophageal.
GERD: gastro-esophageal reflux disease.
GI: gastro-intestinal.
GIST: gastro-intestinal stromal tumor.
GRP: gastrin-releasing peptide.
JIB: jejuno-ileal bypass.
LAGB: laparoscopic adjustable gastric banding.
LES: lower esophageal sphincter.
LSG: laparoscopic sleeve gastrectomy.
LGP: laparoscopic gastric plication.
MALT: mucosa-associated lymphoid tissue.
MAO: mean acid output.
MRI: magnetic resonance imaging.
NIH: National Health Institution.
PET: positron emission tomography.
PPIs: proton-pump inhibitors.
RYGB: Roux Y gastric bypass.
VBG: vertical banded gastroplasty.
VG: virtual gastroscopy.
VIP: vasoactive intestinal peptide.

ZES: Zollinger-Ellison syndrome.

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