Evaluating the evidence for a liver shrinkage diet for obese patients prior to laparoscopic cholecystectomy: A systematic review and meta-analysis.

IF 1 4区医学 Q3 SURGERY

Journal of Minimal Access Surgery Pub Date : 2024-01-01 Epub Date: 2024-01-13 DOI:10.4103/jmas.jmas_142_23

Daniel Llwyd Hughes, Mohamed Elmasry, Iain Wilson, Jihène El Kafsi

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引用次数: 0

Abstract

Background: The role of a very low-calorie diet (VLCD) before cholecystectomy in obese patients is unclear. This study evaluated whether VLCD could be used as a risk mitigation strategy for this high-risk patient cohort.

Patients and methods: A systematic review and meta-analysis was performed (PROSPERO ID CRD42022374610). The primary outcome was to determine the impact of pre-operative VLCD on the operative findings and ease of dissection during laparoscopic cholecystectomy (LC).

Results: Two studies were included with a total of 84 patients. VLCD was associated with a significantly easier Calot's dissection (MD: -0.58 (95% confidence interval [CI] [ -1.03, -0.13], P = 0.01) and was associated with a significantly higher rate of pre-operative weight loss (MD; 2.92 (95% CI [2.23, 3.62], P = 0.00001).

Conclusions: The published evidence regarding VLCD before cholecystectomy in obese patients is limited. After acknowledging the limitations of the data, VLCD is associated with a significantly higher rate of weight loss preoperatively and directly impacts the ease of intraoperative dissection of Calot's triangle. Routine use of VLCD should be considered for all obese patients undergoing elective LC.

查看原文本刊更多论文

腹腔镜胆囊切除术前肥胖患者缩肝饮食的证据评估：系统回顾和荟萃分析。

背景：胆囊切除术前超低卡路里饮食（VLCD）在肥胖患者中的作用尚不明确。本研究评估了超低卡路里饮食是否可作为这一高风险患者群体的风险缓解策略：进行了系统回顾和荟萃分析（PROSPERO ID CRD42022374610）。主要结果是确定术前 VLCD 对腹腔镜胆囊切除术（LC）中手术结果和剥离难易程度的影响：结果：共纳入了两项研究，共计 84 名患者。VLCD 与卡洛氏解剖明显更容易相关（MD：-0.58（95% 置信区间 [CI][-1.03，-0.13]，P = 0.01），与术前体重减轻率明显更高相关（MD；2.92（95% CI [2.23，3.62]，P = 0.00001）：已发表的有关肥胖患者胆囊切除术前 VLCD 的证据有限。在承认数据的局限性后，VLCD 与术前体重减轻率显著提高相关，并直接影响术中解剖卡洛氏三角区的难易程度。所有接受择期 LC 手术的肥胖患者都应考虑常规使用 VLCD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Minimal Access Surgery SURGERY-

CiteScore

1.70

自引率

0.00%

发文量

151

审稿时长

36 weeks

期刊介绍： Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.