The effect of bougie size and distance from the pylorus on dehydration after laparoscopic sleeve gastrectomy: an analysis of the ACS-MBSAQIP database.

•Dehydration is the most common cause for readmission following laparoscopic sleeve gastrectomy.•Many technical aspects of laparoscopic sleeve gastrectomy, including the size of the bougie and the distance from the pylorus, are not standardized across institutions or surgeons.•These technical aspects of laparoscopic sleeve gastrectomy have been postulated to be associated with the rate of dehydration following laparoscopic sleeve gastrectomy.•Using the ACS-MBSAQIP database, we found that patients whose sleeve gastrectomy is begun ≥ 4 centimeters from the pylorus with a bougie size <36 French are least likely to experience dehydration following laparoscopic sleeve gastrectomy compared to any other combination of bougie size and distance from the pylorus.•We believe that a more standardized approach to laparoscopic sleeve gastrectomy may facilitate a decrease in early readmission rates and will lead to a substantial cost-savings benefit.