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Langenbeck's Archives of Surgery

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Open Access 01-12-2024 | Insulins | Research

Effect of preoperative oral carbohydrates on insulin resistance in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial

Authors: Xiaohan Wang, Jingwen Zhuang, Jianxin Cheng, Zeyang Wang, Jingyi Sheng, Shanshan Guo, Rui Wang, Zhiping Wang

Published in: Langenbeck's Archives of Surgery | Issue 1/2024

Abstract

Purpose

The present research seeks to clarify the consequences of two specific preoperative oral carbohydrate (POC) amounts on insulin resistance (IR) and stomach evacuation in laparoscopic cholecystectomy (LC) patients.

Methods

A total of 129 patients set for elective LC procedures were randomly assigned to a control group (C, n = 45), a 200 mL POC group (P1, n = 42), and a 400 mL POC group (P2, n = 42). The C group was fasted from midnight until surgery, whereas the P1 and P2 groups received their respective carbohydrate volumes 2–4 h before anesthesia. Fasting blood glucose, insulin, and glucagon concentrations were measured at three junctures. IR metrics were derived by employing the homeostasis model assessment. Gastric volume was measured before anesthesia using gastric ultrasound. Inter-group comparisons included IR indicators, subjective comfort scores, and hemodynamic data.

Results

At T2, the C group exhibited reduced glucose concentrations compared to the P2 group (4.73 ± 0.64 vs. 5.26 ± 1.02 mmol/L, p < 0.05). The Perlas grading indicated that grade 1 was more prevalent in the P2 group than in the P1 and C groups (18 [42.9%] vs. 6 [14.3%] and 1 [2.2%], p < 0.05). Additionally, thirst and hunger metrics for the P2 group were notably reduced compared to the C group at both T2 and T3.

Conclusion

Administering either 200 mL or 400 mL of carbohydrates 2–4 h pre-surgery had no detectable impact on IR or gastric volume in LC patients.

Trial registration

ChiCTR, ChiCTR2200065648. Registered January 13, 2023, http://www.chictr.org.cn.

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Title: Effect of preoperative oral carbohydrates on insulin resistance in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial
Authors: Xiaohan Wang
Jingwen Zhuang
Jianxin Cheng
Zeyang Wang
Jingyi Sheng
Shanshan Guo
Rui Wang
Zhiping Wang
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Insulins
Insulins
Cholecystectomy
Published in: Langenbeck's Archives of Surgery / Issue 1/2024
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-024-03268-1

At a glance: The STEP trials

Springer Medicine

Effect of preoperative oral carbohydrates on insulin resistance in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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