Skip to main content
SpringerLink
Log in

Perioperative and Postoperative Effects of Preoperative Low-Calorie Restrictive Diets on Patients Undergoing Laparoscopic Sleeve Gastrectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Objective

A restrictive diet applied before bariatric surgery can be required to reduce the liver volume or as a necessity imposed by insurance companies. However, the benefits of preoperative weight loss remain controversial. The present study aimed to investigate the perioperative and postoperative outcomes of a restrictive diet applied before laparoscopic sleeve gastrectomy.

Materials and Methods

The data of 128 patients who received surgery in 2015 and 2016 were retrospectively analyzed. All patients were advised to follow a 4-week low-calorie (1000 cal) restrictive diet. Nevertheless, approximately 50% of patients did not accept the diet plan. We divided the patients into two groups as dieters (group 1) and non-dieters (group 2).

Results

In group 1, changes in after-diet BMI and liver size were statistically significant (p < 0.001). In group 2, mean operation duration, mean hospitalization duration values, mean BMI values, and mean body weight at postoperative 1, 3, 6, and 12 months were statistically significantly higher than in group 1. No statistically significant difference was found between early complication rates of the groups (p = 0.844).

Conclusion

Low-calorie restrictive diet applied before laparoscopic sleeve gastrectomy has reduced liver volume and shortens surgery and hospitalization time but does not have any significance concerning early complications and weight loss after operation in 1 year. Also, non-adherence of the bariatric surgery candidate patients to the diet seems to be a challenge.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, Mc Innis RJ, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010 ;363(23):2211–2219.

    Article  CAS  Google Scholar 

  2. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional,metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery Obesity (Silver Spring, Md). 2013;21(1):1–27.

    Article  Google Scholar 

  3. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8(8):CD003641.

    Google Scholar 

  4. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–1832.

    Article  CAS  Google Scholar 

  5. Espinet Coll E, Nebreda Durán J, López-Nava Breviere G, Ducóns García J, Rodríguez-Téllez M, Crespo García J, et al. Multicenter study on the safety of bariatric endoscopy. Rev Esp Enferm Dig. 2017;109(5):350–357.

    PubMed  Google Scholar 

  6. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery an updated systematic review and meta-analysis, 2003-2012, JAMA Surg.2014;149(3):275–287.

    Article  Google Scholar 

  7. Rached AA, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol. 2014;20(38):13904–13910

    Article  Google Scholar 

  8. López-Nava Breviere G, Bautista-Castaño I, Fernández-Corbelle JP, Trell M. Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management. Rev Esp Enferm Dig. 2016;108:201–206.

    Article  Google Scholar 

  9. Sowier A, Pyda P, Borucka AM, Sowier S, Białecki J, Kapturzak J. Initial experience with endoscopic sleeve gastroplasty in Poland; Pol Przegl Chir. 2018: 90 (2): 16–22.

    Article  Google Scholar 

  10. Berry MA, Urrutia L, Lamoza P, Molina A, Luna E, Parra F, et al. Sleeve gastrectomy outcomes in patients with BMI between 30 and 35–3 years of follow-up. Obesity Surgery. 2018;28(3):649–655.

    Article  Google Scholar 

  11. Hutcheon DA, Hale AL, Ewing JA, Miller M, Couto F, Bour ES, et al. Short-term preoperative weight loss and postoperative outcomes in bariatric surgery. Journal of the American College of Surgeons. 2018;226 (4):514–524.

    Article  Google Scholar 

  12. Holderbaum M, Casagrande DS, Sussenbach S, Buss C. Effects of very low calorie diets on liver size and weight loss in the preoperative period of bariatric surgery: a systematic review . Surgery for Obesity and Related Diseases. 2018;14 (2):237–244.

    Article  Google Scholar 

  13. Colles SL, Dixon JB, Marks P, Strauss BI, O'Brien PE. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84(2):304–311.

    Article  CAS  Google Scholar 

  14. Van Wissen J, Bakker N, Doodeman HJ, Jansma EP, Bonjer HJ, Houdijk APJ. Preoperative methods to reduce liver volume in bariatric surgery: a systematic review. Obesity Surgery. 2016;26:251–256.

    Article  Google Scholar 

  15. Gerber P, Anderin C, Thorell A. Weight loss prior to bariatric surgery: an updated review of the literature. Scandinavian Journal of Surgery. 2014;11(1): 33–39

    Article  Google Scholar 

  16. Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A, et al : Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–145.

    Article  Google Scholar 

  17. Ying LD, Duffy AJ, Roberts KE, Ghiassi S, Hubbard MO, Nadzam GS. Impact of preoperative wait time due to insurance-mandated medically supervised diets on weight loss after sleeve gastrectomy. Are patients losing momentum? Surgery for Obesity and Related Diseases. 2017;13 (9): 1584–1589

    Article  Google Scholar 

  18. Giordano S, Victorzon M. The impact of preoperative weight loss before laparoscopic gastric bypass. Obes Surg. 2014;24:669–674.

    Article  Google Scholar 

  19. Zerrweck C, Maunoury V, Caiazzo R, Branche J, Dezfoulian G, Bulois P, et al. Preoperative weight loss with intragastric balloon decreases the risk of significant adverse outcomes of laparoscopic gastric bypass in super-super obese patients. Obes Surg. 2012;22:777–782

    Article  Google Scholar 

  20. Schneider A, Hutcheon D. A, Hale A, Ewing JA, Miller M, Scott JD. Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program Surgery for Obesity and Related Diseases. 2018;14(5):623–630

    Article  Google Scholar 

  21. Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, van Dielen F, Wiezer R, Janssen I, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146:1300–1305.

    Article  Google Scholar 

  22. Riess KP, Baker MT, Lambert PJ, Mathiason MA, Kothari SN. Effect of preoperative weight loss on laparoscopic gastric bypass outcomes. Surg Obes Relat Dis. 2008;4:704–708.

    Article  Google Scholar 

  23. Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142:994–998

    Article  Google Scholar 

  24. Edholm D, Kullberg J, Haenni A, Karlsson FA, Alhström A, Hedberg J, et al. Preoperative 4-week low-calorie diet reduces liver volume and intrahepatic fat, and facilitates laparoscopic gastric bypass in morbidly obese. Obes Surg. 2011;21:345–350.

    Article  Google Scholar 

  25. Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18:772–775.

    Article  Google Scholar 

  26. Sherman WE, Lane AE, Mangieri CW, Choi YU, Faler BJ. Does preoperative weight change predict postoperative weight loss after laparoscopic sleeve gastrectomy? Bariatric Surgical Practice and Patient Care. 2015;10(3):126–129.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Administration Department, İstanbul Gelişim University Health Sciences Colleges, Tahtakale mah. Abdi ipekçi cad. Avrupa konutları 3 1B Blok No: 98 Avcılar, İstanbul, Turkey

    Ugur Ekici

  2. General Surgery Department, Okan University, İstanbul, Turkey

    Murat Ferhat Ferhatoglu

Authors
  1. Ugur Ekici
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Murat Ferhat Ferhatoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Uğur Ekici: Conception and design of the work, acquisition and interpretation of the data, drafting the work, final approval, responsible for the study.

Murat Ferhat Ferhatoğlu: Analysis and interpretation of the data, revising the work critically, final approval.

Corresponding author

Correspondence to Ugur Ekici.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ekici, U., Ferhatoglu, M. Perioperative and Postoperative Effects of Preoperative Low-Calorie Restrictive Diets on Patients Undergoing Laparoscopic Sleeve Gastrectomy. J Gastrointest Surg 24, 313–319 (2020). https://doi.org/10.1007/s11605-019-04157-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-019-04157-5

Keywords

Search

Navigation