title: Preoperative 4-week supplementation with omega-3 polyunsaturated fatty acids reduces liver volume and facilitates bariatric surgery in morbidly obese patients.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is a very common condition among obese patients that may lead to the enlargement of the liver, that in turn impairs the access to the gastro-esophageal junction during laparoscopic bariatric surgery. Omega-3 polyunsaturated fatty acids (Ω-3 PUFAs) supplementation has been shown to reduce nutritional hepatic steatosis. The aim of this study was to assess the effects of a 4-week course of oral Ω-3 PUFAs supplementation on the volume of the liver.
  
  
  METHODS
  20 morbidly obese patients were administered oral Ω-3 PUFAs (1,500 mg daily) for 4 weeks before undergoing the laparoscopic Roux-en-Y gastric bypass (LRYGBP) without any dietary restriction. The volume of the left hepatic lobe was estimated by liver ultrasonography at baseline and at the end of treatment. The degree of difficulty to access the gastro-esophageal junction was appreciated subjectively by the operating surgeon.
  
  
  RESULTS
  All patients completed the study and no side effect was reported. The mean volume of the left hepatic lobe decreased by 20% from 598 ± 97 to 484 ± 118 cm(3) after the treatment (p = 0.002). The access to the gastro-esophageal junction was reported as simple, with easy retraction of the left hepatic lobe by the operating surgeon in all cases.
  
  
  CONCLUSIONS
  This study demonstrates that a 4-week course of oral Ω-3 PUFAs supplementation results in a significant reduction in liver size that facilitates the LRYGBP.
authors.affiliation: Service de Chirurgie Digestive et Transplantation Hépatique, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet, Pôle Digestif, 151 Route Saint-Antoine de Ginestière, BP 3079, Nice, 06202, Cedex 3, France, antonio_iannelli@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Martini
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Schneck
authors.forename: Bijan
authors.initials: B
authors.lastname: Ghavami
authors.forename: Guillaume
authors.initials: G
authors.lastname: Baudin
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Anty
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
mesh_terms: D000284:Administration, Oral; D000328:Adult; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005234:Fatty Liver / Q000178:diet therapy / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005602:France / Q000453:epidemiology; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009767:Obesity, Morbid / Q000150:complications* / Q000178:diet therapy / Q000503:physiopathology / Q000601:surgery; D009929:Organ Size; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015525:Fatty Acids, Omega-3