Authors: David Edholm Joel Kullberg Arvo Haenni F Anders Karlsson Anders Ahlström Jakob Hedberg Håkan Ahlström Magnus Sundbom
Publish Date: 2010/12/22
Volume: 21, Issue: 3, Pages: 345-350
Abstract
The aim of this study was to explore changes in liver volume and intrahepatic fat in morbidly obese patients during 4 weeks of lowcalorie diet LCD before surgery and to investigate if these changes would facilitate the following laparoscopic gastric bypassFifteen female patients 1213 kg BMI 429 were treated preoperatively in an open study with LCD 800–1100 kcal/day during 4 weeks Liver volume and fat content were assessed by magnetic resonance imaging and spectroscopy before and after the LCD treatmentLiver appearance and the complexity of the surgery were scored at the operation Eighteen control patients 1144 kg BMI 408 without LCD were scored similarly Average weight loss in the LCD group was 75 kg giving a mean weight of 1139 kg at surgery Liver volume decreased by 12 p 0001 and intrahepatic fat by 40 p 0001 According to the preoperative scoring the size of the left liver lobe sharpness of the liver edge and exposure of the hiatal region were improved in the LCD group compared to the controls all p 005The overall complexity of the surgery was perceived lower in the LCD group p 005 due to improved exposure and reduced psychological stress both p 005 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
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