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Randomized Controlled Trial
. 2016 May;18(5):456-61.
doi: 10.1016/j.hpb.2016.01.545. Epub 2016 Mar 8.

A randomised, single blinded trial, assessing the effect of a two week preoperative very low calorie diet on laparoscopic cholecystectomy in obese patients

Katherine M Burnand  1 , Rajiv P Lahiri  1 , Nicholas Burr  1 , Lize Jansen van Rensburg  2 , Michael P N Lewis  3
Affiliations
Randomized Controlled Trial

A randomised, single blinded trial, assessing the effect of a two week preoperative very low calorie diet on laparoscopic cholecystectomy in obese patients

Katherine M Burnand et al. HPB (Oxford). 2016 May.

Abstract

Background: Laparoscopic cholecystectomy (LC) can be technically challenging in the obese. The primary aim of the trial was to establish whether following a Very Low Calorie Diet (VLCD) for two weeks pre-operatively reduces operation time. Secondary outcomes included perceived operative difficulty and length of hospital stay.

Methods: A single-blinded, randomized controlled trial of consecutive patients with symptomatic gallstones and BMI >30 kg/m(2) 46 patients were randomized to a VLCD or normal diet for two weeks prior to LC. Food diaries were used to document dietary intake. The primary outcome measure was operation time. Secondary outcomes were length of stay, weight change operative complications, day case rates and perceived difficulty of operation.

Results: The VLCD was well tolerated and had significantly greater preoperative weight loss (3.48 kg vs. 0.98 kg; p < 0.0001). Median operative time was significantly reduced by 6 min in the VLCD group (25 vs. 31 min; p = 0.0096). There were no differences in post-operative complications, length of stay, or day case rates between the groups. Dissection of Calot's triangle was deemed significantly easier in the VLCD group.

Conclusion: A two week VLCD prior to elective laparoscopic cholecystectomy in obese patients is safe, well tolerated and was shown to significantly reduce pre-operative weight and operative time.

Isrctn: 61630192. http://www.isrctn.com/ISRCTN61630192 Trial registration.

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Figures

Figure 1
Figure 1
CONSORT diagram of this study
Figure 2
Figure 2
a. Perceived ease of Calot's dissection by surgeon, b. Perceived ease of fundal retraction by surgeon, c. Perceived ease of liver displacement by surgeon
See this image and copyright information in PMC

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