Extended Preoperative Liquid Diet: Safety First in Bariatrics

Ran B Luo, MD, Shanglei Liu, MD, Jonathan C DeLong, MD, Alisa M Coker, MD, Caitlin Houghton, MD, Bryan J Sandler, MD, FACS, Garth R Jacobsen, MD, FACS, Santiago Horgan, MD, FACS. University of California, San Diego

This video demonstrates the management of hepatomegaly during a laparoscopic sleeve gastrectomy. The patient presented with a starting BMI of 46, which decreased to 42 after enrolling in our pre-bariatric weight loss management program. She was placed on a liquid diet for 2 weeks as per our protocol. The initial laparoscopic attempt was aborted due to both the size and the weight of her liver. She was then placed on a liquid diet for 6 weeks to decrease the liver size further and underwent a successful sleeve Gastrectomy at the second operation. The initial exploration and subsequent operation with a focus on the decrease in liver size, creation of the sleeve Gastrectomy, plication, intra-operative endoscopy, and post-operative fluoroscopic studies are shown and described.

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