Abstract
Background
Low caloric diet can reduce liver volume; however, there is no consensus regarding preoperative weight reduction before bariatric surgery. This study evaluates the effect of preoperative very-lowcalorie diet (VLCD) in patients undergoing laparoscopic sleeve gastrectomy (LSG).
Methods
This prospective study included patients scheduled for LSG stratified into two groups, Diet Group (n = 183) who followed a preoperative VLCD regimen for three weeks and underwent assessment of the liver lobes span before and after regimen, and Control Group (n = 138) who underwent sonographic assessment once before surgery and were operated upon without diet. The outcome measures were the impact of preoperative diet on the liver span, intraoperative complications, anthropometric factors affecting the liver span.
Results
Diet regimen resulted in a significant reduction of the right and left lobes. The percentage of the reduction of the left lobe span was significantly higher than that of the right lobe (p < 0.001). Change of the size of the two lobes was correlated positively with weight and body mass index and initial size of both lobes. There was no significant difference between the two groups in the frequency of operative complications.
Conclusion
VLCD for three weeks before bariatric surgery effectively reduced liver size. The reduction is more in the left lobe. The changes of both lobes were correlated well with the pre- and post-regimen weight and BMI. It was also positively correlated with the initial size of both lobes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K et al (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377:13–27
Colquitt JL, Pickett K, Loveman E, Frampton GK (2014) Surgery for weight loss in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003641.pub4
Nightingale CE, Margarson MP, Shearer E, Redman JW, Lucas DN, Cousins JM et al (2015) Peri-operative management of the obese surgical patient 2015. Anaesthesia 70:859–876
Schwartz ML, Drew RL, Chazin-Caldie M (2003) Laparoscopic Roux-en-Y gastric bypass: preoperative determinants of prolonged operative times, conversion to open gastric bypasses, and postoperative complications. Obes Surg 13:734–738
Colles SL, Dixon JB, Marks P, Strauss BJ, O’Brien PE (2006) Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr 84:304–311
Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A et al (2007) Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis 3:141–145 (discussion 145–146)
Cassie S, Menezes C, Birch DW, Shi X, Karmali S (2011) Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis 7:760–767 (discussion 767)
O’Brien PE, Dixon JB, Brown W, Schachter LM, Chapman L, Burn AJ et al (2002) The laparoscopic adjustable gastric band (lap-band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg 12:652–660
Busetto L (2001) Visceral obesity and the metabolic syndrome: effects of weight loss. Nutr Metab Cardiovasc Dis 11:195–204
Gerber P, Anderin C, Thorell A (2015) Weight loss prior to bariatric surgery: an updated review of the literature. Scand J Surg 104(1):33–39
Nieuwenhove YV, Dambrauskas Z, Campillo-Soto A, van Dielen F, Wiezer R, Janssen I et al (2011) Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. Am Med Assoc 146:1300–1305
van Wissen J, Bakker N, Doodeman HJ, Jansma EP, Bonjer HJ, Houdijk APJ (2016) Preoperative methods to reduce liver volume in bariatric surgery: a systematic review. Obes Surg 26:251–256
Riestra-Candelaria BL, Rodríguez-Mojica W, Vázquez-Quiñones LE, Jorge JC (2016) Ultrasound accuracy of liver length measurement with cadaveric specimens. J Diagn Med Sonogr 32:12–19
Childs JT, Esterman AJ, Thoirs KA (2014) Ultrasound measurements of the liver: an intra and inter-rater reliability study. Australas J Ultrasound Med 17:113–119
Riestra-Candelaria BL, Rodriguez-Mojica W, Jorge JC (2018) Anatomical criteria to measure the adult right liver lobe by ultrasound. Sonography 5:181–186
Childs JT, Thoirs KA, Esterman AJ (2016) The development of a practical and uncomplicated predictive equation to determine liver volume from simple linear ultrasound measurements of the liver. Radiography 22:e125–e130
Fris RJ (2004) Preoperative low energy diet diminishes liver size. Obes Surg 14:1165–1170
Lewis MC, Phillips ML, Slavotinek JP, Kow L, Thompson CH, Toouli J (2006) Change in liver size and fat content after treatment with optifast very low calorie diet. Obes Surg 16:697–701
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
Drs. Mohamed AbdAlla Salman, Mohamed Gamal Qassem, Mohamed Saad Aboul-Enein, Mahmoud A.Ameen, Ahmed Abdallah, Hitham Omar, Ahmed Mahmoud Hussein, Mohamed Sabry Tourky, Khaled Monazea,Ahmed M.Hassan,Ahmed Salman,Ahmed Moustafa,Hossam El-Din Shaaban,Ahmed Soliman and Mohamed D Sarhan have no conflicts of interest or financial ties to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Salman, M.A., Qassem, M.G., Aboul-Enein, M.S. et al. Effect of preoperative diet regimen on liver size before laparoscopic sleeve gastrectomy in morbidly obese patients. Surg Endosc 36, 2981–2986 (2022). https://doi.org/10.1007/s00464-021-08592-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-021-08592-x