Li Z, Wu WZ, Song Y, Li ZP, Guo D, Li Y. Early gastric dilation after laparoscopic sleeve gastrectomy: Insights from a three-dimensional computed tomography reconstruction study. World J Gastrointest Surg 2026; 18(1): 112251 [PMID: 41695879 DOI: 10.4240/wjgs.v18.i1.112251]
Corresponding Author of This Article
Yu Li, Chief Physician, Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. liyu11920@qdu.edu.cn
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Gastroenterology & Hepatology
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Retrospective Study
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Jan 27, 2026 (publication date) through Feb 19, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Li Z, Wu WZ, Song Y, Li ZP, Guo D, Li Y. Early gastric dilation after laparoscopic sleeve gastrectomy: Insights from a three-dimensional computed tomography reconstruction study. World J Gastrointest Surg 2026; 18(1): 112251 [PMID: 41695879 DOI: 10.4240/wjgs.v18.i1.112251]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 112251 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.112251
Early gastric dilation after laparoscopic sleeve gastrectomy: Insights from a three-dimensional computed tomography reconstruction study
Zhao Li, Wen-Zhi Wu, Yi Song, Zhao-Peng Li, Dong Guo, Yu Li
Zhao Li, Wen-Zhi Wu, Yi Song, Dong Guo, Yu Li, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Zhao-Peng Li, Department of Hepatobiliary Surgery, Shandong Second Provincial General Hospital, Jinan 250022, Shandong Province, China
Co-first authors: Zhao Li and Wen-Zhi Wu.
Author contributions: Li Z contributed to the conceptualization, design, and data analysis of the study; Wu WZ was responsible for data acquisition and manuscript editing; Li Z and Wu WZ contributed equally to this article, they are the co-first authors of this manuscript; Song Y handled the data and statistical analysis; Li ZP contributed to data acquisition and manuscript review; Guo D conducted clinical studies and participated in manuscript review; Li Y performed the literature review and contributed to writing, reviewing, and editing the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Qingdao University, approval No. QYFY WZLL 28969.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.
Corresponding author: Yu Li, Chief Physician, Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. liyu11920@qdu.edu.cn
Received: July 22, 2025 Revised: September 15, 2025 Accepted: November 20, 2025 Published online: January 27, 2026 Processing time: 183 Days and 19.9 Hours
Abstract
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric surgery owing to its effective weight loss and low complication rates. Nonetheless, some patients experience weight regain or insufficient weight loss due to residual gastric dilation, the factors of which remain unclear.
AIM
To evaluate changes in residual gastric volume after LSG using three-dimensional computed tomography reconstruction and to investigate the factors contributing to gastric dilation.
METHODS
This retrospective study included 50 patients who underwent LSG. Preoperative clinical and laboratory data were obtained. The residual gastric volume was measured using three-dimensional computed tomography reconstruction at 1 month and 3 months postoperatively. The total sleeve volume, tube volume, antral volume, and tube-to-antral volume ratio were also assessed. Resected gastric volume and staple line length were measured during surgery. Weight metrics and laboratory indices were recorded at 1 month, 3 months, 6 months, and 12 months postoperatively. The Eating Behavior After Bariatric Surgery Questionnaire and Gastroesophageal Reflux Disease Questionnaire (GERD-Q) were used to assess the dietary behavior of patients after LSG. Correlation between the degree of residual gastric dilation and percent total weight loss (%TWL) at 12 months postoperatively was analyzed. Univariate and multivariate correlation analyses were conducted to identify risk factors for residual gastric dilation after LSG.
RESULTS
The 50 included patients had a mean preoperative body mass index of 42.27 ± 7.19 kg/m2 and average %TWL of 34% ± 7% at 1 year after LSG. At 1 month after LSG, the mean tube volume, antral volume, and total sleeve volume were 45.93 ± 16.75 mL, 115.85 ± 44.92 mL, and 161.77 ± 55.37 mL, respectively. At 3 months after LSG, the residual gastric volume showed statistically significant dilation (average dilation degree: 13.50% ± 17.35%). %TWL at 1 year significantly correlated with residual gastric dilation (P < 0.05). Univariate and multivariate linear regression analyses revealed that preoperative type 2 diabetes, residual gastric volume at 1 month after LSG, and GERD-Q scores were independent risk factors influencing the degree of residual gastric dilation.
CONCLUSION
In conclusion, residual gastric dilation after LSG significantly affected the efficacy of weight loss. Preoperative type 2 diabetes, residual gastric volume at 1 month after LSG, and GERD-Q scores were independent risk factors affecting the degree of residual gastric dilation.
Core Tip: This study leverages three-dimensional computed tomography reconstruction to analyze the early dilation of the residual stomach post-laparoscopic sleeve gastrectomy. It identifies significant factors influencing gastric dilation, including preoperative type 2 diabetes, initial postoperative residual gastric volume, and Gastroesophageal Reflux Disease Questionnaire scores, underlining their impact on long-term weight loss efficacy. These insights could enhance patient selection and postoperative management strategies, potentially improving surgical outcomes.
