Preoperative 4-Week Low-Calorie Diet Reduces Liver Volume and Intrahepatic Fat, and Facilitates Laparoscopic Gastric Bypass in Morbidly Obese

Abstract

The overall complexity of the surgery was perceived lower in the LCD group (p < 0.05), due to improved exposure and reduced psychological stress (both p < 0.05). Four weeks of preoperative LCD resulted in a significant decrease in liver volume and intrahepatic fat content, and facilitated the subsequent laparoscopic gastric bypass as scored by the surgeon.

Preoperative Transabdominal Ultrasonography (US) Prior to Laparoscopic Roux-en-Y Gastric Bypass (LRYGBP) and Laparoscopic Sleeve Gastrectomy (LSG) in the First 100 Operations. Was It Beneficial and Reliable During the Learning Curve?

“…Enlarged left lobe of the liver obscures the gastro-oesophageal junction and makes the division of the small gastric pouch and creation of the gastrojejunostomy difficult. In addition, traction to a fatty liver may cause trauma with increased risk of bleeding [20]. In other series [21], the decision to perform a sleeve gastrectomy and not a gastric bypass was taken intraoperatively due to hepatomegaly.…”

Weight loss prior to bariatric surgery: An updated review of the literature

“…In these uncontrolled studies, LoS as a parameter obviously suffers from several biases, some of the most important being the time relationship between changes in routines for postoperative hospital stay and preoperative dietary recommendations, increased hospital volume and surgical skills. Accordingly, in several studies, the authors have not been able to find any differences in LoS in patients who did versus those who did not lose weight preoperatively (7,14,15,18,21,22). In the only randomized study in which LoS was commented on (18), no beneficial effect could be demonstrated between groups.…”

“…In some of these (11,15,20), the findings suggest a reduction in complication rates in response to preoperative weight reduction, whereas other report no beneficial effect (7,14,18,19,21). In addition to the conflicting results, these studies suffer from the weaknesses of the non-randomized design and/or limited number of included patients.…”

Peri-operative management of the obese surgical patient 2015

“…There is evidence that 2–6 weeks of intense pre‐operative dieting can improve respiratory function and facilitate laparoscopic surgery, and may be worth considering in the higher risk patients 44.…”