Preoperative Very Low-Calorie Diet Reduces Technical Difficulty During Laparoscopic Cholecystectomy in Obese Patients. Issue 3 (June 2016)

• Record Type: Journal Article
• Authors: Jones, Alexander D.; Waterland, Peter W.; Powell-Brett, Sarah; Super, Paul; Richardson, Martin; Bowley, Douglas
• Is Part Of: Surgical laparoscopy endoscopy & percutaneous techniques. Volume 26:Issue 3(2016)
• Publication Date: 2016-06
• Subjects: calorie restriction -- laparoscopic cholecystectomy -- technical difficulty -- obesity; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Endoscopy -- Periodicals; Laparoscopy -- Periodicals; 617.550597
• DOI: 10.1097/SLE.0000000000000278
• Languages: English
• ISSNs: 1530-4515

Abstract

Abstract : This study investigates the effectiveness of preoperative very low-calorie diet (VLCD) in laparoscopic cholecystectomy. A prospective observational study of consecutive patients undergoing laparoscopic cholecystectomy was undertaken. At the preoperative visit, all patients were advised to adhere to VLCD for 2 weeks before surgery (<800 kcal/d). Patients were judged to have complied with the VLCD if weight loss >2 kg. Technical difficulty was assessed using questionnaires. A total of 38 patients met the inclusion criteria. Difficulty of visualization and dissection of Calot's triangle in obese patients was twice that of nonobese patients ( P =0.01). In 62% of procedures involving obese VLCD noncompliant patients, the surgeon experienced ≥1 area of technical difficulty, compared with 0% of procedures on obese, compliant patients ( P =0.018). Difficulty of dissection of the gallbladder bed was 3 times higher in obese, noncompliant patients, compared with obese, compliant patients ( P =0.07). Adherence to a 2-week preoperative VLCD may reduce technical difficulty of laparoscopic cholecystectomy in obese patients.