Effectiveness of a Low-Calorie Diet for Liver Volume Reduction Prior to Bariatric Surgery: a Systematic Review
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REVIEW
Effectiveness of a Low-Calorie Diet for Liver Volume Reduction Prior to Bariatric Surgery: a Systematic Review Marleen M. Romeijn 1 & Aniek M. Kolen 1,2 & Daniëlle D. B. Holthuijsen 1,2 & Loes Janssen 1 & Goof Schep 3 & Wouter K. G. Leclercq 1 & François M. H. van Dielen 1 Received: 30 July 2020 / Revised: 14 October 2020 / Accepted: 21 October 2020 # The Author(s) 2020
Abstract An energy-restricted diet is often prescribed before bariatric surgery to reduce weight and liver volume. While verylow-calorie diets (VLCDs, 450–800 kcal per day) have shown to be effective, the effectiveness of low-calorie diets (LCDs, 800–1500 kcal per day) is less obvious. The objective of this systematic review was to elucidate the effectiveness of LCD on liver volume reduction in patients awaiting bariatric surgery. Eight studies (n = 251) were included describing nine different diets (800–1200 kcal, 2–8 weeks). An LCD was effective in liver volume reduction (12–27%) and weight loss (4–17%), particularly during the first weeks. The LCD showed an acceptable patients’ compliance. Based on these findings, an LCD (800–1200 kcal), instead of a VLCD, for 2 to 4 weeks should be preferred. Keywords Bariatric surgery . Low-calorie diet . Liver volume . Preoperative diet
Abbreviations BMI Body mass index LBM Lean body mass LCD Low-calorie diet NAFLD Nonalcoholic fatty liver disease RCT Randomized controlled trial TWL Total weight loss VLCD Very-low-calorie diet
Introduction Bariatric surgery is considered the most effective treatment for severe obesity as it promotes long-term weight loss and reduces or controls obesity-related comorbidities [1]. The incidence of short-term life-threatening complications is considered relatively low (1–5% for anastomotic leakage and bleeding) [2, 3] but depends on the patients’ comorbidities and technical difficulties that are encountered during surgery. In
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s11695-02005070-6. * Marleen M. Romeijn [email protected]; [email protected]
Wouter K. G. Leclercq [email protected] François M. H. van Dielen [email protected]
Aniek M. Kolen [email protected] Daniëlle D. B. Holthuijsen [email protected]
1
Department of Surgery, Máxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands
2
Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands
3
Department of Sport Medicine, Máxima Medical Center, De Run 4600, Veldhoven 5504 DB, The Netherlands
Loes Janssen [email protected] Goof Schep [email protected]
OBES SURG
obese patients, technical difficulties are related to increased abdominal wall thickness, increased visceral adiposity and the presence of an enlarged liver. All these factors may contribute to reduced intra-abdominal space, reduced freedom of surgical movement and limited exposure of the gastric cardia, making the surgery technicall
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