Clinical Impact of a 6-Week Preoperative Very Low Calorie Diet on Body Weight and Liver Size in Morbidly Obese Patients

González-Pérez, J.A.; Sánchez-Leenheer, Sofía; Rivas‐Delgado, Alfredo; González-Vargas, Lizbeth; Díaz-Zamudio, Mariana; Montejo, Gerardo; Críales, Sergio; Williams, Nicholas; Pantoja, Juan Pablo; Sierra, Mauricio; Velázquez-Fernández, David; Herrera, Miguel F.

doi:10.1007/s11695-013-0977-0

Cited by 44 publications

(42 citation statements)

References 18 publications

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“…These patients lost a median of 11 kg (3-21) of body weight in a median time of two months of conservative support by our team of dietitians. A strict diet significantly reduces liver size within a short time (6,7). The feasibility of laparoscopic bariatric procedures increases as liver size decreases.…”

Section: Resultsmentioning

confidence: 99%

“…However, laparoscopic RYGBP is associated with less postoperative pain, lower wound infection rates, shorter hospital stays and reduced incidences of late incisional hernia compared with open gastric bypass [6][7][8]. Therefore, superobese patients benefit from a laparoscopic approach because they tend to experience a greater incidence of postoperative complications, including superficial and deep wound infections, respiratory decompensation and 30-day mortality (13,14).…”

Section: Resultsmentioning

confidence: 99%

“…Preoperative weight reduction has been shown to decrease intra-abdominal fat mass and liver volume (6,7). Additionally, large registry studies have demonstrated that the risk of postoperative complications is markedly reduced following preoperative weight reduction, especially in patients in the higher BMI range (8).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

How to cope with insufficient pneumoperitoneum and exposure when performing laparoscopic gastric bypass surgery

Scotland

Widmer

Wildi

et al. 2016

Langenbecks Arch Surg

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K (2016). How to cope with insufficient pneumoperitoneum and exposure when performing laparoscopic gastric bypass surgery. Langenbeck's Archives of Surgery, 401(3) AbstractObjective: Despite following international guidelines and conducting routine preoperative dietary counseling, every bariatric surgeon will encounter technical challenges in laparoscopic gastric bypass surgery. We present a series of patients in whom the bariatric procedure was stopped after encountering insufficient exposure during diagnostic laparoscopy. These patients were sent back for dietary counseling and underwent surgery after conservative weight loss. The data from this two-step procedure are analyzed and discussed.Methods: This concept was applied and studied in 14 patients from a series of 620 bariatric procedures. Patients who underwent a primary laparoscopic gastric bypass (n=593) were used as references.Results: The patients in the study group were significantly heavier than those in the reference group (165 kg vs. 127 kg, p<0.001), with 79% a BMI >50 kg/m 2 . The patients lost a median of 11 kg after two months of conservative treatment, and the mean BMI decreased from 55.7 to 52.6 kg/m 2 . All patients in the study group underwent laparoscopic surgery for the second procedure with no need for conversion. The complication rate was not elevated in the study group. Overall hospital costs were higher for the study group compared with the primary laparoscopic bypass group (27,136 vs. 19,601 USD, p=0.034).Conclusion: The primary laparoscopic procedure can be stopped in patients with insufficient exposure instead of undergoing conversion to open surgery. These patients may undergo successful laparoscopic procedures after conservative weight loss with no increased risk and with all of the possible benefits of a laparoscopic approach. As a result of this study, we have established a fixed, preoperative lower limit of 10% excess weight reduction before accepting superobese patients (BMI >50 kg/m 2 ) for surgery at our hospital.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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How to cope with insufficient pneumoperitoneum and exposure when performing laparoscopic gastric bypass surgery

Scotland

Widmer

Wildi

et al. 2016

Langenbecks Arch Surg

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show abstract

“…The benefits on regularity of sleep cycle and increased concentration are seen even earlier. Prior to bariatric surgery, most patients are put on a Bprebariatric surgery diet^for approximately 1 to 6 weeks [30]. Surgical teams should consider the use of CPAP during this period.…”

Section: How Does Excess Fat Make Anesthesia Different?mentioning

confidence: 99%

Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Singh

2015

OBES SURG

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Over the last four decades, as the rates of obesity have increased, so have the challenges associated with its anesthetic management. In the present review, we discuss perioperative anesthesia management issues that are modifiable by the early involvement of the surgical team. We sum up available evidence or expert opinion on issues like patient positioning, postoperative analgesia, and the effect of continuous positive airway pressure (CPAP) ventilation on surgical anastomosis. We also address established predictors of higher perioperative risk and suggest possible management strategies and concerns of obese patients undergoing same day procedures. Finally, a generalized pharmacological model relevant to altered pharmacokinetics in these patients is presented.

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“…However, high weight and visceral fat associated with an enlarged liver ( aspects of this surgery [3,4]. Several studies concerning preoperative diets, such as meal replacement diets [5][6][7][8][9][10], intragastric balloons [11], pharmacologic therapy [12,13], or home ingredients [14], have reported decreased weight and/or liver size. However, to our knowledge, no studies have been performed regarding the preoperative Mediterranean diet, a type of eating pattern that promotes lifelong good health and has beneficial effects on the prevalence and progression of metabolic syndrome [15].…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of Mediterranean-enriched-protein diet on liver size, visceral fat, fat mass, and fat-free mass in patients undergoing sleeve gastrectomy

Schiavo

Scalera

Renato

et al. 2015

Surgery for Obesity and Related Diseases

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Clinical Impact of a 6-Week Preoperative Very Low Calorie Diet on Body Weight and Liver Size in Morbidly Obese Patients

Cited by 44 publications

References 18 publications

How to cope with insufficient pneumoperitoneum and exposure when performing laparoscopic gastric bypass surgery

How to cope with insufficient pneumoperitoneum and exposure when performing laparoscopic gastric bypass surgery

Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Clinical impact of Mediterranean-enriched-protein diet on liver size, visceral fat, fat mass, and fat-free mass in patients undergoing sleeve gastrectomy

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