Original CommunicationShort-term preoperative diet modification reduces steatosis and blood loss in patients undergoing liver resection
Section snippets
Methods
This study was approved by the Dartmouth Committee for the Protection of Human Subjects, study 22273. We retrospectively evaluated steatosis and steatohepatitis in all patients who underwent major hepatic resection by a single surgeon (R.J.B.) between June 2005 and March 2012. The most recent group of 51 patients was given explicit written dietary instructions by their surgeon and were requested to follow the diet at home for 1 week before resection; the 60 control patients were not given any
Results
We observed that steatosis and steatohepatitis were common in the control group: mild hepatic steatosis was present in 43% of the patients, moderate or severe hepatic steatosis was present in 33%, and steatohepatitis (NAS ≥ 4) was present in 27% (Table III). Steatosis and steatohepatitis were less common in the 21 control patients with BMI <25: only 19% of patients in this subset had moderate or severe steatosis, and only 10% had steatohepatitis. In contrast, 42% of the subset of patients with
Discussion
To the best of our knowledge, our study is the first to demonstrate histologically that a short-term, low-calorie diet as the sole intervention can result in decreased hepatic steatosis and steatohepatitis. The nonrandomized design of this study may lead one to question whether factors other than the preoperative diet were responsible for these observed differences in steatosis and steatohepatitis. We believe that this is very unlikely. In linear regression analysis, the only factor other than
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