pre op: is your liver really fat?

so my surgeon requires a pre op 14 day liquid diet to shrink the liver. 

why shrink the liver if it hasn't been diagnosed as enlarged which they can feel by touch?

i have a friend who was sleeved and she was only required by her surgeon to only do 3 days pre op. mind you she was almost 2 of me. her liver was find during surgery. so what's really the deets on this? 

When they say "liver shrink," what they are really doing is trying to get you, through a low-carb diet, to reduce the stored glycogen in your liver.

Glycogen is how animals store carbohydrates.  Glycogen is stored in the liver, but also in the muscles.  When we are low-carb dieting, our cells break down this glycogen using a hormone called glucagon (released by the pancreas; it's the antagonist to insulin) which converts the stored glycogen to glucose that our cells can readily use.

Glycogen has a tendency to hold water in, which is one of the reasons why when one does a low-carb diet, the initial weight you lose is all water weight.  This glycogen can make the liver's surface very slippery and thus difficult for the surgeon to work with. 

My surgeon told my husband after I got out of surgery that my liver was still large, but he worked around it.  He also said that my liver would shrink as I lost weight, and that for the liver to be slightly enlarged was due to my obesity.  Additionally, he also did a liver biopsy while I was under to determine if I had fatty liver disease.  As an aside, I pre-op dieted for 3 weeks on an extremely low carb diet.

Hope this is helpful. 

I just love it that you're a science teacher!  You explain things really well - thanks! 

Thanks! I love teaching others...it is a lot of fun!

Thank you so much for that explanation.  I've been a Nurse for 38 years and sure I'd forgotten all that.  My Doc instructed me to do 7 days of liquids, but I decided to do 14, so hopefully my liver will be in great shape.  I'm going to ask my Doc to weigh and take a picture of the part of my stomach he removes.  Visuals can be very motivating.

You're welcome. I'm a biology teacher and we talk about this in class when we learn about cell signaling and communication.

I asked for the operation notes and got the pathology report at my first follow-up and read about how big the piece of my stomach was that was removed.

I made my doc save my stomach so I could see it the next morning.  I appreciated being able to say goodbye to it. 

I only did a 3 day pre-op per my doctor based on my starting BMI...should have done two weeks.  Dr had to biopsy my liver because it was so fatty...he wanted to make sure it wasn't permanently damaged.  My pre-op bloodwork showed no indication of liver issues.  If nothing else, it's a jump start on your weight loss!

cool. what was your starting bmi?

I have read on several others posts on this site that 14 days is not enough time  to affect the fat in your liver to make the surgery easier for the surgeon, it would help you get in more of a habit of eating differently, if you weren't already doing that.  JMHO though.  :)