How do they tell without opening you up that you have a fatty liver? Or is that something they have to open you up and can not proceed with the procedure if you havent lost enough fat around the liver?

As far as I'm aware, the only way they know is to "open you up" and take a look - and if it's not good enough close you up and try again another day.

All the more reason to stick to that pre-op diet!

My experience leading up to surgery was elevated liver enzymes on my cholesterol blood work. This is either due to the cholesterol meds I was on, or according to my surgeon, a fatty liver. I was put on the two week pre-op liquid diet (ended up being 3 weeks because I caught a cold and my surgery was bumped a week--not enough time to stop and restart the pre-op diet). The surgeon also told me that if my liver looked fatty when he did the surgery he would sample it for a biopsy. After surgery he told me my liver didn't look that bad. My first blood work post-surgery still had elevated enzymes, so my PCP stopped my cholesterol meds (as well as one BP med, a reflux med, and I wasn't using the CPAP anyway). I just recently had blood work off meds for 6 months. My numbers are still in the normal range AND my liver enzymes are finally normal. It was the cholesterol meds after all.

Talk to your surgeon. They probably have a similar approach. The pre-op diet helps to shrink the liver, but I don't know that they can tell if it is fatty until they get in to put in the band. Clearly it wasn't going to stop mine, just get me a biopsy, but I didn't need it. If you think you may have a fatty liver and they put you on the liquid diet, stick to it. It can only help. Good luck with your journey.

I had to have an abdominal ultrasound for just this reason. I was pleased to hear I had one of the skinniest livers of any bariatric patient the tech had seen. Go team me I guess !

I had blood work, ultrasound, etc etc...and a 3 week preop diet and still when opened up my liver was too thick. I agree if you are given a preop diet follow it TO THE LETTER. No cheating. No modifying it.

Thank you all!! I appreciate the information very much!!!

I just had an ultrasound done on my liver because my alt and ast?? enzymes were slightly elevated and the result came back as a fatty liver. My pcp said that I didnt need to see a specialist at this point and didn't recommend me do anything different. My paperwork just got sent in to Tricare for the band approval yesterday (and I will get approved according to the insurance guidlines), but I'm so worried that even with the pre op diet my liver will still be too big!! Is fatty liver synonomus with a big or 'thick' liver? I think I'm going to start a south beach type diet now just incase my surgery date is quick! Anyone else have this situation when they were about to get banded??:confused:

My ferritin levels on the blood work were high and they did an ultrasound to check it. It came back with a diagnosis of fatty liver. One thing you have to realize is that most obese people have fatty liver. The pre-op diet is to shrink it as much as they can. On rare occassions they do get in there for surgery and find that the liver is still too big. However, like I said this is rare. I asked my PCP when my ferritin levels would come down and he told me it could take years to heal. The good thing is - it will go down.

I know how worried you are about that. Try to relax. This is why the surgeries are done is to improve this type of thing. Talk to your surgeon about your worries. If you're like me, you didn't because of fear of what the answer would be (i.e. no surgery).

I also had a fatty liver prior to surgery.

I was nervous as heck that my liver would STILL be to fatty. I followed my 2wk pre-op diet exactly as given - no cheating.

I was perfectly fine. :scared2:)

Good Luck and I hope all goes well!

My ferritin levels on the blood work were high and they did an ultrasound to check it. It came back with a diagnosis of fatty liver. One thing you have to realize is that most obese people have fatty liver. The pre-op diet is to shrink it as much as they can. On rare occassions they do get in there for surgery and find that the liver is still too big. However, like I said this is rare. I asked my PCP when my ferritin levels would come down and he told me it could take years to heal. The good thing is - it will go down.

I know how worried you are about that. Try to relax. This is why the surgeries are done is to improve this type of thing. Talk to your surgeon about your worries. If you're like me, you didn't because of fear of what the answer would be (i.e. no surgery).

Thank you for responding. You saying that most obese people have fatty liver makes really good sense. Thanks for pointing that out:) ..And you're right on the mark about me not asking the doc! I did tell him that my enzymes were elevated though.. Thanks again

wow my doc didn't even mention anything about a fatty liver, he didn't ever require a pre-op diet. I decided to do one myself tho to jump start everything!

Well, I'm glad everything worked out alright for you then!! I didn't know until my consult what the pre op diet actually accomplished. My doc just said it makes the surgery alot safer with a little liver.

thanks! so far so good wooohooo!!!

Back in the mid 1990's I had a blood test show high liver enzymes. Since I worked in manufacturing, the concern was it was from something at work. I had a bunch of test ran and finally a liver biopsy. It was determined fat in my liver and I was put on a diet. Once I lost a few pounds the liver enzymes came back down to normal.

Prior to banding, the liver enzymes were elevated again. As mentioned in the thread earlier, this is common in obese people. My PCP checks me with a full blood panel work up every 6 months. My liver enzymes have been normal since banding.

I had to do an Atkins diet for 7 days prior to banding surgery. My surgeon says my liver was small and easy to work around. He said he could tell I follow my diet. It took 20-30 minutes to install my band. A lady that was banded after me, took my surgeon almost an hour and a half to do her surgery as she had failed to do her pre-op diet. She also ate a regular last meal the night before. My surgeon was not happy with her. He spent extra time with her explaining the importance of following his instructions with her before he came over to release me from the hospital.

So, does the pre-op diet help? Yes!

Is it important to follow it to the letter? Yes!

If your doctor does not prescribe a pre-op diet, should you do one any way? It cannot hurt. If anything it will help with surgery.

Most pre-op diets are either an Atkins type diet or a clear liquid diet for 1-2 weeks prior to surgery. I hope this helps.

Amen, Andyisbanded! Do what your doc says! I'm living proof! :thumbup:

Amen, Andy is banded! You are so correct. Obesity increases the fat on/around the organs, including the liver. the pre-op diet helps deal with that as the liver must be moved to insert the band. Smaller liver makes it easier. My PCP said i had a fatty liver based on blood tests. But the surgeon had no problem . Yes, i followed the diet to the letter.