VALIDATION OF POUCH SIZE MEASUREMENT FOLLOWING THE SWEDISH ADJUSTABLEGASTRIC BANDING USING ENDOSCOPY, MRI AND BARIUM SWALLOW

Background: Pouch volume appears to be of major importance for subsequ ent weight loss following any gastric restriction type of surgery for morbid obesity. In order to be able to evaluate pouch volume following Swedish Adjustable Gastric Banding (SAGE), an endoscopic pouch volume classification system was designed in which pouch volume is classifie d in five categories. The aim of this study was to validate the endosc opic classification system using MRI and barium swallow as reference m ethods for pouch volume measurement. Methods: Twenty patients (13 wome n and seven men) were operated for obesity with SAGE. They were invest igated a mean of 3 years (6 weeks-5.5 years) after surgery and had at that time lost a mean of 60 (12-112)kg. During the same afternoon they sequentially underwent endoscopy, MRI and barium swallow with an empt y stomach. Results: The mean pouch volume measured with MRI was 70 mi (0-180 mi) and with barium swallow was 72 mi (0-195 mi). In 17/20 pati ents the volume as measured by MRI and barium swallow was in the same volume category as with endoscopy. The correlation measured according to Pearson was significant between endoscopy on one hand and MRI/bariu m swallow both independently and together (p < 0.001). Conclusion: Bas ed on these results we are confident in using our endoscopic classific ation system for postoperative follow-up of pouch volume.