Preoperative 4-Week Supplementation with Omega-3 Polyunsaturated Fatty Acids Reduces Liver Volume and Facilitates Bariatric Surgery in Morbidly Obese Patients

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 (Omega-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 Omega-3 PUFAs supplementation on the volume of the liver. 20 morbidly obese patients were administered oral Omega-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. 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. This study demonstrates that a 4-week course of oral Omega-3 PUFAs supplementation results in a significant reduction in liver size that facilitates the LRYGBP.