Pre-Operative Liver Reduction Diet Plan

Pre-Operative Liver Reduction Diet Plan

You will need to follow an exceptionally strict diet for 3 weeks before your operation.

This reduces the size of your liver and makes surgery possible with a much-reduced risk of complications.

If you do not follow the advice meticulously then your surgeon may not be able to carry out the operation.

Your liver is a large organ inside the abdomen that lies over your stomach and needs to be moved aside during surgery.

In people of a larger body size, the liver tends to be particularly large with expanded stores of glycogen (a form of carbohydrate), water and fatty deposits.

Following one of the recommended diet plans will reduce these stores so the overall size of your liver will shrink. Your liver can then be safely moved aside during the operation so that your surgery can be carried out.

What if I have diabetes?

If you have diabetes and take medication or injections, it is important that you have spoken to a member of the team before starting your pre-op diet, and that you understand any changes that have been recommended.

If you take insulin, you should be referred to a Diabetes Specialist Nurse for an initial assessment before starting the pre op diet, and it is your responsibility to keep in contact with your nurse if you have any queries before or after surgery.

PRE-OP DIET OPTIONS
Option 1 Meal replacements- up to 4 per day (total 900 calories).

You cannot eat any of your usual daily foods during this pre-op diet.
You will find a variety of meal replacement shakes and powders in supermarkets and pharmacies, for example Celebrity Slim, Slimfast, Superdrug Slenderplan, Forza Shake It Slim, Tesco SLIM, Asda Great Shape Meal Replacement Shakes, or Morrisons In Shape Meal Replacement Shakes. They contain a range of vitamins and minerals and contain approximately 200 calories per item.

Most meal replacement drinks are milk based, but Celebrity Slim, Optifast, and LighterLife do offer some savoury options.

Some varieties are ready to drink, but others need to be made up with water or skimmed milk. It is important to make up the drinks exactly as directed to ensure you are getting the correct balance of nutrients.

Meal replacement bars can also be used e.g. Slimfast or Celebrity Slim. They can replace 1 of your meal replacement shakes.

Dairy free options
Celebrity Slim has a range of diary and gluten free meal replacement powders, and Purition has a range of dairy free and vegan meal replacement powders. Check with your dietitian that your dairy free milk and meal replacement combination is suitable. Slimfast VI+ALITY range is also dairy free.

If you find other alternatives not listed here please speak with your Dietitian who will be able to advise you. Only use alternatives if your dietitian agrees.

Follow these instructions regardless of whether you choose option 1,2 or 3

• Spread your food and drink out over the day.
• Drink a minimum of 2 litres of allowed fluids every day (more if the weather is hot or if you sweat more than usual).
• Drink at regular intervals throughout the day. Include unlimited amounts of water, no added sugar squash, other beverages such as Oxo, (or other powdered stock cubes) dissolved in water, bovril, tea, and coffee.
• Do not use sugar in your drinks but you can use a sweetener if you wish.
• Do NOT drink alcohol
• Take a multivitamin/mineral tablet daily from when you start the pre op diet.
• Monitor your bowel action, as you may need to take a laxative

Option 2 Milk and Yogurt

You cannot eat any of your usual daily foods during this pre-op diet.
Each day you can have:

• 1 pint (600mls) semi-skimmed milk AND approx. 8-10 x 125g pots of Diet yogurt

AND 7-10 yogurts per day as specified below

• Activia 0% fat & no added sugar yogurt. 115g pot provides 60 calories. (8-10)
• Danone Light & Free 0% fat and 0% sugar. 115g pot provides 55 calories (8-10)
• Morrisons 0% Fat Greek Style yogurt Raspberry or coconut. 125g provides 63 calories (8-10)
• Asda light Fat Free Greek style yogurts. 125 provides 60 calories (8-10)
• Sainsburys Clonakilty Irish Yogurts Diet fat Free.125g provides 66 calories (8-10)
• Aldi Brooklea light 175g provides 76 calories (7-8)
• Muller Light Fat Free Yogurt 0% added sugar 160g provides 78 calories (7-8)
• Light and Free SKYR YOGURT 150g pot provides 80 calories (7-8)
• Other varieties of yogurt may also be suitable but please check with your dietitian.
• You can choose skimmed milk if you prefer but not full fat milk.

Ensure yogurts are approx. 60-70 calories (kcals) per 125g pot and you can include 8- 10 per day. If they contain more calories, you will need to eat less yogurts as above. If you find other yogurts not listed here please speak with your Dietitian who will be able to advise you on their suitability.

Remember to follow general instructions on the bottom of page 2 of this pack.

Option 3 Milk Diet

Each day you can have

• 3 pints of semi skimmed milk and 1 portion of fruit OR
• 3 pints of skimmed milk and 2 portions of fruit

What is a portion?
1 medium apple, or banana, or pear, or peach, or a slice (2 inch) of melon or
2 medium plums, or 2 small satsumas, or 2 kiwi fruits. 80g per portion

Choose which diet you are going to use and follow it strictly for 3 weeks. It is useful to try some meal bars and meal replacement milkshakes and soups leading up to the pre-op diet so that you can see which diet you prefer.

You cannot eat any of your usual daily foods during this option.
You can follow a different option for each week if you wish.

Our contact details

Please contact the bariatric team, who have formulated these diet plans, using the telephone numbers below, depending on the nature of your query.

If your call is urgent you can call 01905 763333 and the switchboard will page your Dietitian or Specialist Nurse during their working hours given below.

During evenings, weekends or Bank Holidays, or for conditions unrelated to your bariatric surgery please contact your GP or call NHS 111.

If you are very unwell, please attend the A&E department.

Bariatric Nurse Specialists
Monday – Fridays 08:00 – 16:00 01905 733965

Specialist Bariatric Dietitians
Monday – Fridays 08:00 – 16:00 01905 733965

Bariatric Secretaries
Secretary to Mr Perry 01905 760363
Secretary to Mr Wadley 01905 733022
Secretary to Mr S J Robinson 01527 503030 ext. 44337

Appointments Co-ordinator 01905 768947

Email [email protected]

NHS 111
Tel: 111
Email: www.nhs.uk/111

Updated November 2022

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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