Question:
What happens if your liver doesnt shrink as much as the doctor hoped?

Hi. I am having RNY on 1/05. I have posted several questions on here and everyone has been very helpful. I have a very curious question. I am doing a 4 week HMR diet which is basically protein drinks and water. I was wondering what happens if my liver doesnt shrink that much. Do the doctors cancel surgery? I would hate for that to happen?    — jackie L. (posted on December 25, 2008)

December 25, 2008
I wouldnt worry about it too much unless you have been doing alot of cheaten. Im not sure unless you had a ultrasound if you even have an enlarged liver. My surgeon required a 2 week preop clear liquid plus shakes. I cheated a couple times with a protein like tuna salad. Of course you should follow dr's orders.. I think they will know if you didint follow directions if you didint have weight loss. I lost 15 lbs in 2 weeks. Congrats and goodluck. This has been the best thing Ive ever done for myself
   — urbrat2

December 25, 2008
I followed everything that my surgeon said because I had heard the same stories (from the doctor, himself!!) Some story about how he would stop in mid procedure if the liver had not shrunk enough for his satisfaction. Being scared of that, I followed the liquid diet and protein drinks and lost 15# during the 2 weeks of protein drinks before surgery. I wanted to lose more, but he didn't stop my surgery in mid stroke, so I was pretty happy about that. Good luck....and if you ever need any guidance or a shoulder to lean on....just contact me at myspace.com/babsisforever....good luck!! Barb
   — Barb

December 25, 2008
If you follow the diet the doctor gave you, then you have nothing to worry about. My doctor told me my liver did not have any fat left in it and was impressed by the size, yet it was not a fatty liver. My operation went as planned and all went well.
   — cydthekid50

December 25, 2008
Most of the time if the liver does not shrink enough the surgeons choose to do the open procedure. Instead of using laparoscopic instruments they open you abdomibal cavity. It's a nasty scar and the recoup period is much longer. This type of procedure involves more risks. But if you follow your doctors onstructions you shouldn't worry about it. Good luck.
   — maria09elena

December 25, 2008
My Dr. told me it was better to have a non-fatty liver to make the procedure easier. After words he told me that due to the fact that I had shed 20 lbs in 2 weeks it had helped with the size of my liver and also the ease of my recovery. Stick to the plan that your Dr. has given you, after all he has done this before as it is he is the professional and should have your best interest at heart. Good luck and welcome to the losers bench.
   — *****GIGS *******

December 26, 2008
They can pretty much guarentee that the liver is shrunk judging by your weight loss the month before surgery...If you don't loss weight the doc might actually cancel until you do! I have heard that happen. But they wouldn't usually got thru the trouble and costs of putting you under and getting you prepped only to cancel. It's not difficult to lose 10-20 lbs before surgery! You can do it! Work hard and get your surgery...You have a few weeks to really focus! After surgery, you will be glad you did...because that's when the real fun begins! And in a year you will be so happy....Good luck!
   — .Anita R.

December 26, 2008
What would happen would be the surgeon would begin the surgery and not be able to perform the WLS and pull out. If you were to have some type of test before hand such as Cat Scan or something and he saw your liver was too large, he would cancel. If you follow the diet and don't cheat, you should be fine. Best of luck, Dawn Vickers, RN, BLC, CLC
   — DawnVic

December 26, 2008
As "Maria" said, if your liver does not shrink enough, they will opt to do the surgery "open" instead of laproscopically. The purpose of the liquid diet is to shrink the liver and make it more pliable so that they can easily move it around with their instruments while they are in there. If that is not possible, they will NOT cancel the surgery, they will just open you up instead with a vertical incision from between your breasts to down around the belly button. You will sign consents before you "go under" in order that they have all their bases covered and are able to switch to open if necessary. Good luck with your surgery.
   — anitak

December 26, 2008
The liver is an organ that looses volume, meaning weight along with you when you loose weight in general. So if you loose weight your liver will become smaller in size. I was unable to do that protein diet but I did weight watchers before my surgery and lost about 30 Lbs and they were able to get in safely and place my Lap band with no problem and initially I did have a fatty liver. Don't stress yourself out over that, you should be fine.. Santos
   — cancelsbronx

December 26, 2008
I had Gallbladder surgery one month prior to my Gastric Bypass. My surgeon advised me that my liver was absolutely too large and if she gave me a 2 week liquid diet to follow prior to surgery. I done it, and lost 21 lbs and also had a perfect size liver then. Just don't cheat and follow it closely you'll be fine.
   — Katrina B.

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