Preoperative Diet for Gallbladder Surgery

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Preoperative Diet for Gallbladder Surgery

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Gallbladder Surgery

This dietary restriction is designed to reduce your operating risk and should not be followed long term.

Preoperative Diet for

Information for patients

Before your gall bladder surgery, it is essential that you follow a special diet for two weeks. This diet is to help shrink the liver so the surgeon can operate more easily. This increases the chances of your surgery being performed safely with a laparoscopic (keyhole) operation.

Following the diet is an essential part of the preparation for your operation. It should not be continued after your surgery or by anyone else.

Why do I need to follow this diet?

When performing gall bladder surgery via a keyhole (laparoscopic) operation, the surgeon will have to lift the liver to get to the gall bladder. If the liver is heavy, fatty and immobile, it is much more difficult for the surgeon to see and gain access to the gall bladder.

Following this diet will encourage the body to use up the stores of glycogen (a form of sugar stored in the liver and muscles for energy). This results in the liver ‘shrinking’ in size and softening.

By following this diet, you are likely to lose weight before surgery but, more importantly, your liver will shrink, and you increase your chances of having a safe operation. It is important to stick to the diet for the full two weeks before your operation. Do not be tempted to have a special/larger meal before surgery, as this will reverse the liver-reducing effects of the diet.

During your diet

Keep hydrated: Drink a minimum of 2 litres of fluid a day. This includes drinks of any type, but remember these count in your recommended calorie intake so choose low calorie options e.g. water, sugar free squash, tea, herbal teas, low calorie flavoured water. Avoid alcohol.

Take a vitamin and mineral tablet every day.

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What does the diet involve?

It is important that you follow the exact recommendations below. This is designed to significantly reduce the calorie and carbohydrate content of your diet, and provide valuable nutrients needed for general health. Foods high in carbohydrate include sugars and starch food. The starchy carbohydrate foods include bread, rice, potato, pasta and cereals; therefore, it is necessary to temporarily avoid these.

There are three different plans available:

1. Food plan: Normal foods using carefully measured portions of carbohydrate.

2. Milk or alternative dairy plan

3. Meal replacement plan

The following plans will provide approximately 800 calories a day.

1. Food plan

This diet is low in carbohydrate and fat (although how low will depend on the foods you choose) and moderate in protein. It is important to measure your portions accurately or you may end up eating too much and the diet will not work. Aim to eat three meals a day.

Food source Portions per day Examples

Protein foods 3 100g Cooked lean meat, low fat 5% mince, chicken breast (no skin) or turkey 100g cooked white fish or tinned tuna in brine or water

2 medium eggs 100g low fat cottage cheese 80g tofu 150g Quorn pieces/mince

Dairy 2 200ml skimmed or semi-skimmed milk or soya, nut or other non-dairy milk alternative fortified with calcium

1 small pot of low fat, low sugar, diet or fat free yogurt or soya yogurt

Vegetables 5

1 portion of any type of vegetables or salad = 80g (excluding potatoes, yam, pulses, beans and lentils)

Fruit 2

1 portion is approximately palm size (80g) :

1 medium sized piece of fruit e.g. apple, pear

2 small pieces of fruit e.g. Satsumas, plums

1 palm of loose fruit e.g. grapes, strawberries

Do not use or cook with oils, butter or margarine. You can use low calorie cooking sprays. Avoid high fat foods such as sausages, pastry, pies or crisps.

Do not use any type pf sugar or honey or eat any food high in sugar e.g. cake, chocolates, sweets or fruit juice. You can use artificial sweeteners.

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. Milk or alternative dairy plan

Each day you should have:

3 pints of skimmed, semi-skimmed or 1% fat milk or soya, nut or non-dairy alternative.

2 pots or up to 200g 0% fat and low sugar or soya yoghurts (labelled as ‘light’ or ‘diet’).

Alternatively you may substitute one pot of yoghurt for 200g of low fat cottage cheese

or fat free quark

In addition to this you may have any amount of:

 Tea (no sugar, milk from 3 pint allowance)

 Coffee (no sugar, milk from 3 pint allowance)

 Low calorie or diet fizzy drinks

 Low calorie squash

 Sugar free jelly

 Water

It is important that you drink additional fluid (as well as the 3 pints of milk) per day in order to prevent dehydration.

3. Meal replacement plan

This approach consists of mainly liquid formulas supplying around 800 calories per day. There are many companies that make these liquid formulas which contain a balance of nutrients that your body needs. Some companies provide options of sweet (shakes) and savoury products (soups).

Depending on the calorie content of the product, you will need 3-4 per day. It is important to check the label and do not exceed around 800Kcal in total.

Each shake/soup needs to provide around 200-300Kcals and 12-25g protein per serving. They contain fibre, vitamin and minerals. A lot of the shakes are quite high in sugar, so please take time to read the nutritional information. Drink them slowly, rather than drinking all in one go.

Diabetes

If you have diabetes and are treated with tablet medication and/ or insulin it is likely that these medications will need adjusting. This diet will contain little or less carbohydrate than your usual diet and can increase risk of hypoglycaemia. You will need to monitor your diabetes control more closely during this time. Please contact your diabetes specialist nurse/practice nurse/GP before starting the pre-operative diet.

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Royal United Hospitals Bath NHS Foundation Trust Combe Park, Bath, BA1 3NG

01225 428331 | www.ruh.nhs.uk

Constipation

Constipation may occur whilst following this diet as you will be eating a lot less than usual. Please make sure you drink plenty of fluids. You may require laxatives or fibre supplements (e.g. Fybogel) to help reduce your symptoms. Your local pharmacy or GP should be able to advise you on appropriate medication.

For any queries, please contact:

Nutrition & Dietetic services: RUH: 01225 824398 or St Martins: 01225 833916

If you would like this leaflet in email form, large print, braille or another language, please contact the Patient Support and Complaints team on 01225 825656.

Date of publication: March 2024 | Ref: RUH DSU/051 © Royal United Hospitals Bath NHS Foundation Trust

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