Sleeve Gastrectomy bougie calibration with 34F vs 60F: weight loss, nutritional intake and quality of life

Camilo Boza, MD, Diego Barros, MD, Ana Palacio, Jose Salinas, MD, Ricardo Funke, MD, Gustavo Perez, MD, Fernando Crovari, MD, Alejandro Raddatz, MD

Pontificia Universidad Catolica de Chile

Introduction: There are various technical aspects in sleeve gastrectomy that may affect the results in terms of weight loss and complications. Bougie size for calibration is controversial. The objective of this study is to compare patients operated of LSG with bougies 34F and 60F in terms of complications, weight loss and nutritional intake.

Methods: Non concurrent cohort study of patients with BMI between 35 and 50 kg/m2 undergoing LSG as a single procedure with 34F and 60F bougie sleeve calibration. Demographic, clinical characteristics, comorbidities, postoperative complications and outcomes were studied. Nutritional intake was documented and quality of life was evaluated according to a written survey.

Results: Sixty eight patients met the inclusion criteria. Comorbidities in our series were 5.9% Diabetes Mellitus, Insulin resistance 64.7%, 20.6% hypertension, dyslipidemia and hypothyroidism 45.6% 14.7%. The median age was 33 years (18-60), median preoperative BMI was 39.1 kg/m2. (35.3-47.6), 85% of the series were women. Age, BMI and preoperative overweight did not differ significantly between the two groups. The 12-month follow-up was 78%. The median percentage of excess weight loss was with 34F and 60F bougies respectively: 32.5% and 33.4% at 1 month (p = NS), 42.5% and 45.5% at 2 months (p = NS), 78.0% and 65.2% at 6 months (p = 0.001), 90.1% and 69.2% at 12 months (p = 0.002). Patients operated with a 60F bougie showed greater food intake volume at 1 month (p = 0.009), at 2 months (p <0.001) and at 6 months (p<0.001), higher average number of meals at 2 months (p = 0.03) and satisfaction at one month (p = 0.018). Nutritional analysis shows that patients with 60F bougie have better food intake but both groups are below recommended nutritional status.

Conclusion: Sleeve gastrectomy is an effective procedure; a 34F bougie calibration is associated with better outcomes in excess weight loss at 6 and 12 months follow-up. Bougie size calibration does not affect the quality of life of patients at 12 months follow up. Patients undergoing sleeve gastrectomy require nutritional supplement for not meeting the recommended nutritional requirements.

Session: Poster Presentation

Program Number: P446

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