Perioperative Nutritional Therapy in Bariatric Surgery: A Case Report

Fiona Desi Amelia, Febe Christianto

Abstract


Background: Metabolic and bariatric surgery, such as laparoscopic sleeve gastrectomy (LSG), is effective for obese patients with type 2 diabetes mellitus (DM), proven to improve metabolic profiles, control hyperglycemia, and provide DM remission in 55-85% of patients, as well as reducing medication use and body weight (BW) within one year after surgery. Case Report: A 23-year-old female patient with grade II obesity (BMI 31.42 kg/m²), DM, and cholecystolithiasis underwent laparoscopic cholecystectomy and LSG. Perioperative clinical nutrition therapy was performed to support the success of the surgery, including BW management, a preoperative diet through the Enhanced Recovery After Surgery (ERAS) protocol, and a gradual postoperative diet from liquid consistency. Evaluation 5 days after surgery showed decreased BW, waist circumference, body fat mass, visceral fat, and HbA1C without complications. The patient was discharged on the 6th day and was advised to adopt a transitional diet, multivitamins, and calcium supplementation. The mechanism of LSG involves calorie restriction, early satiety due to decreased gastric volume, and faster gastric emptying time. Conclusion: Short-term perioperative LSG nutrition therapy aims to meet nutritional needs, support weight loss, and improve metabolic profiles, thus contributing to clinical success for patients with obesity, type 2 diabetes, and metabolic syndrome.


Keywords


Bariatric, laparoscopic sleeve gastrectomy, perioperative nutrition, weight loss, metabolic profile

Full Text:

PDF

References


Tang Q, Sun Z, Zhang N, Xu G, Song P, Xu L, et al. Cost-Effectiveness of Bariatric Surgery for Type 2 Diabetes Mellitus. Med (United States). 2016; 95(20):1–9.

Andromalos L, Crowley N, Brown J, Craggs-Dino L, Handu D, Isom K, et al. Nutrition Care in Bariatric Surgery: An Academy Evidence Analysis Center Systematic Review. J Acad Nutr Diet [Internet]. 2019; 119(4):678–86. Available from: https://doi.org/10.1016/j.jand.2018.08.002

Dagan SS, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, et al. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr An Int Rev J. 2017; 8(2):382–94.

Batterham RL, Cummings DE. Mechanisms of diabetes improvement following bariatric/metabolic surgery. Diabetes Care. 2016; 39(6):893–901.

Boles A, Kandimalla R, Reddy PH. Dynamics of diabetes and obesity: Epidemiological perspective. Biochim Biophys Acta - Mol Basis Dis [Internet]. 2017; 1863(5):1026–36. Available from: http://dx.doi.org/10.1016/j.BWadis.2017.01.016

Bommer C, Heesemann E, Sagalova V, Manne-Goehler J, Atun R, Bärnighausen T, et al. The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study. Lancet Diabetes Endocrinol. 2017; 5(6):423–30.

Moss TR. Hospital length of stay and healthcare costs among African American women due to obesity and diabetic conditions in United States: A model for correlation studies comparing ethnicity, comorbidities and hospital resources. Chronic Dis Transl Med [Internet]. 2018; 4(4):244–53. Available from: https://doi.org/10.1016/j.cdtm.2018.11.002

Handzlik-Orlik G, Holecki M, Orlik B, Wylelol M, Dulawa J. Nutrition management of the post-bariatric surgery patient. Nutr Clin Pract. 2015; 30(3):383–92.

Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: State of the art. Nat Rev Gastroenterol Hepatol [Internet]. 2017; 14(3):160–9. Available from: http://dx.doi.org/10.1038/nrgastro.2016.170

Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract [Internet]. 2014;2014:943162. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L372757012%5Cnhttp://dx.doi.org/10.1155/2014/943162%5Cnhttp://linksource.ebsco.com/linking.aspx?sid=EMBASE&issn=20900597&id=doi:10.1155/2014/943162&atitle=A+comprehensive+review+on+m

Batsis JA, Romero-Corral A, Collazo-clavell ML, Sarr MG, Somers VK, Lopez-Jimenez F. Effect of Bariatric Surgery on the Metabolic Syndrome: A Population-Based, Long-term Controlled Study. Mayo Clin Proccedings. 2008; 83(August):897–906.

Du X, Fu X hui, Peng B qiang, Luo R, Hu J kun, Cheng Z. Resolution of Metabolic Syndrome and Related Metabolic Disorders after Bariatric Surgery: Comparison of Sleeve Gastrectomy and Gastric Bypass. Off J Am Soc Metab Bariatr Surg. 2018; 1(1):1–35.

Neff KJ, Roux CW Le. Bariatric Surgery : The Indications in Metabolic Disease. Dig Surg. 2014; 31(1):6–12.

Masayuki Ohta SK. Preoperative Evaluation and Preparation for Patients. In: Seung Ho Choi, editor. Bariatric and metabolic surgery. Springer International Publishing; 2014. p. 11–4.

Snyder-Marlow G, Taylor D, Lenhard MJ. Nutrition Care for Patients Undergoing Laparoscopic Sleeve Gastrectomy for Weight Loss. J Am Diet Assoc [Internet]. 2010; 110(4):600–7. Available from: http://dx.doi.org/10.1016/j.jada.2009.12.022

Thibault R, Huber O, Azagury DE, Pichard C. Twelve key nutritional issues in bariatric surgery. Clin Nutr [Internet]. 2016; 35(1):12–7. Available from: http://dx.doi.org/10.1016/j.clnu.2015.02.012

Segaran E. Provision of nutritional support to those experiencing complications following bariatric surgery. Proc Nutr Soc. 2010; 69(4):536–42.

Isom KA, Andromalos L, Ariagno M, Hartman K, Mogensen KM, Stephanides K, et al. Nutrition and metabolic support recommendations for the bariatric patient. Nutr Clin Pract. 2014; 29(6):718–39.

Fullmer MA, Abrams SH, Hrovat K, Mooney L, Scheimann AO, Hillman JB, et al. Nutritional strategy for adolescents undergoing bariatric surgery: Report of a working group of the nutrition committee of NASPGHAN/NACHRI. J Pediatr Gastroenterol Nutr. 2012; 54(1):125–35.

Obeidat F, Shanti H, Mismar A, Albsoul N, Al-Qudah M. The Magnitude of Antral Resection in Laparoscopic Sleeve Gastrectomy and its Relationship to Excess Weight Loss. Obes Surg. 2015; 25(10):1928–32.

Wiradisuria E. Development of Laparoscopic Metabolic and Bariatric Surgery in Indonesia. Jakarta; 2019.

Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis [Internet]. 2015; 11(3):489–506. Available from: http://dx.doi.org/10.1016/j.soard.2015.02.003

Perkeni. Management and Prevention of Type 2 Diabetes Mellitus in Indonesia. 2015;

Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis [Internet]. 2009; 5(6):713–21. Available from: http://dx.doi.org/10.1016/j.soard.2009.08.014




DOI: https://doi.org/10.24815/jds.v9i1.41875

Article Metrics

Abstract view : 0 times
PDF - 0 times

Refbacks

  • There are currently no refbacks.


 

Indexed by:

JDS JDS Garuda JDS JDS JDS

JDS JDS JDS JDS JDS JDS

JDS 

 
Tools:

JDS JDS JDS JDS JDS JDS

JDS JDS JDS

All papers published in FKG  USK Press are licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 

Social Media: