title: A randomised, single blinded trial, assessing the effect of a two week preoperative very low calorie diet on laparoscopic cholecystectomy in obese patients.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  
  
  
  
  61630192. http://www.isrctn.com/ISRCTN61630192 Trial registration.
authors.affiliation: Norfolk & Norwich University Hospital NHS Trust, Norwich, NR4 7UY, UK.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Burnand
authors.affiliation: Norfolk & Norwich University Hospital NHS Trust, Norwich, NR4 7UY, UK.
authors.forename: Rajiv P
authors.initials: RP
authors.lastname: Lahiri
authors.affiliation: Norfolk & Norwich University Hospital NHS Trust, Norwich, NR4 7UY, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Burr
authors.affiliation: Dietetic Department, Lister Hospital, Stevenage, SG1 4AB, UK.
authors.forename: Lize
authors.initials: L
authors.lastname: Jansen van Rensburg
authors.affiliation: Norfolk & Norwich University Hospital NHS Trust, Norwich, NR4 7UY, UK. Electronic address: michael.lewis@nnuh.nhs.uk.
authors.forename: Michael P N
authors.initials: MP
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D031204:Caloric Restriction; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004739:England; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult