Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for patients with morbid obesity, but the optimal gastric volume (GV) for resection remains unclear. Accordingly, we aimed to determine the optimal percentage of excised stomach that could engender significant weight loss and improve fatty liver. This prospective study included 63 patients. Computed tomography (CT) scans were performed before and 1 year after LSG to evaluate the gastric lumen (GL) and GV. Specifically, the stomach was distended with effervescent powder, following water–contrast mixture (20:1) and assessed by three-dimensional reconstruction. The correlations of reduced gastric lumen/volume (RGL/RGV) with total body weight (BW) loss and liver–spleen density ratio (LSDR) changes were analyzed, and optimal RGL/RGV associated with significant BW and fatty liver changes were determined. We noted a positive correlation between the percentage of RGV/RGL (%RGV/%RGL) and percentage of total weight loss (%TWL; = 0.359, = 0.004 and = 0.271, = 0.032). Furthermore, a %RGL value of >78.2% and %RGV value of >75.3% were associated with more significant BW loss than did limited excision (both < 0.01). On the other hand, LSDR values increased significantly after LSG, corresponding to the improvement of fatty liver disease at %RGL and %RGV values of >59.1% and >56.4% (both < 0.01), respectively. %RGV and %RGL were determined to be factors affecting LSG outcomes. LSG engendered significantly more BW loss when %RGV was >75.3% and resulted in fatty liver disease improvement when %RGV was >56.4%.

中文翻译：

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基于计算机断层扫描的胃容量测定病态肥胖，以评估体重减轻和脂肪肝变化

腹腔镜袖状胃切除术（LSG）是病态肥胖患者的有效治疗方法，但切除的最佳胃体积（GV）仍不清楚。因此，我们的目的是确定可以显着减轻体重并改善脂肪肝的最佳切除胃百分比。这项前瞻性研究包括 63 名患者。在 LSG 之前和之后 1 年进行计算机断层扫描 (CT) 扫描，以评估胃腔 (GL) 和 GV。具体来说，用水与造影剂混合物（20:1）用泡腾粉使胃膨胀，并通过三维重建进行评估。分析了胃腔/体积（RGL/RGV）减少与总体重（BW）损失和肝脾密度比（LSDR）变化的相关性，并确定了与显着体重和脂肪肝变化相关的最佳RGL/RGV。我们注意到 RGV/RGL 百分比 (%RGV/%RGL) 与总体重减轻百分比 (%TWL; = 0.359, = 0.004 和 = 0.271, = 0.032) 之间呈正相关。此外，与有限切除相比，> 78.2％的％RGL值和> 75.3％的％RGV值与更显着的体重损失相关（均<0.01）。另一方面，LSG 后 LSDR 值显着增加，对应于脂肪肝疾病的改善，%RGL 和 %RGV 值分别 >59.1% 和 >56.4%（均 < 0.01）。%RGV 和 %RGL 被确定为影响 LSG 结果的因素。当 %RGV > 75.3% 时，LSG 会导致明显更多的体重损失，而当 %RGV > 56.4% 时，LSG 会导致脂肪肝疾病改善。