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01-12-2018 | Original Contributions

Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial

Authors: A. Gils Contreras, A. Bonada Sanjaume, M. Montero Jaime, A. Rabassa Soler, F. Sabench Pereferrer, A. Molina López, N. Becerra Tomás, D. Del Castillo Déjardin, J. Salas-Salvadó

Published in: Obesity Surgery | Issue 12/2018

Abstract

Objective

To assess which type of preoperative dietary strategy is most effective in reducing liver volume and assessing its influence on different biochemical parameters and on surgical complications in individuals undergoing bariatric surgery.

Methods

Parallel randomized trial comparing the effect of a very low calorie diet (VLCD) and a low calorie diet (LCD) for a period of 21 days before surgery on hepatic volume, anthropometric and biochemical parameters. Compliance and tolerance to the diets, surgical complications, and hospital stay were also determined.

Results

Eighty-six morbid obese participants undergoing bariatric surgery were randomized. The hepatic volume was significantly reduced in both intervention groups, but no differences in changes between groups were detected. The reduction in the hepatic volume was higher in those patients with a baseline hepatic volume > 3 L compared to those with < 3 L (adjusted P value < 0.001). The percentages of total weight lost were 5.8 and 4.2% (adjusted P value = 0.004) for participants on the VLCD and LCD, respectively. There were no differences between groups for any of the biochemical parameters analyzed, nor in the number of surgical complications nor the length of hospital stay. Adherence to the diet was good; nevertheless, participants in the VLCD intervention showed worse tolerance.

Conclusions

In subjects with morbid obesity undergoing bariatric surgery, compared to a LCD, a preoperative 21-day intervention with VLCD is more effective in terms of reducing total body weight but not in terms of reducing the liver volume. Both types of preoperative diets have similar effects on clinical biochemical parameters, rate of surgical complications, and hospital length stay.

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Title: Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial
Authors: A. Gils Contreras
A. Bonada Sanjaume
M. Montero Jaime
A. Rabassa Soler
F. Sabench Pereferrer
A. Molina López
N. Becerra Tomás
D. Del Castillo Déjardin
J. Salas-Salvadó
Publication date: 01-12-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 12/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-018-3413-7

At a glance: The STEP trials

Springer Medicine

Effects of Two Preoperatory Weight Loss Diets on Hepatic Volume, Metabolic Parameters, and Surgical Complications in Morbid Obese Bariatric Surgery Candidates: a Randomized Clinical Trial

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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