What question did this study set out to answer?

This study aims to examine the effects of standardized dietary protocols on early postoperative outcomes following different bariatric procedures.

June 26, 2026Open Access

Standardized Pre- and Early Postoperative Dietary Protocols After Bariatric and Metabolic Surgery: A 20-Year Single-Center Experience Across Roux-en-Y Gastric Bypass, Sleeve Gastrectomy, and Ileal Procedures

MCMagda Rosa Ramos da CRUZPontifícia Universidade Católica do Paraná AFAlcides José Branco FilhoAssociates Research FQFelipe Ramos QuadrosPontifícia Universidade Católica do Paraná

Key Points

This study aims to examine the effects of standardized dietary protocols on early postoperative outcomes following different bariatric procedures.
Retrospective cohort study of 622 adults who underwent various bariatric procedures from 2004 to 2024.
Patients followed a 10-day anti-inflammatory preoperative diet and a structured postoperative liquid-to-solid food progression over 30 days.
Early postoperative outcomes included gastrointestinal symptoms and complications such as fistulas or drain requirements.
Overall 9.0% experienced constipation, 2.7% diarrhea, 8.8% vomiting, 2.4% nausea, 0.6% reflux, and 0.2% dumping in the first postoperative month.
Fistulas and drain requirements occurred in 0.5% of patients, while 79.9% remained symptom-free.
Ileal interposition had the highest symptom rate at 29.9%, while Roux-en-Y gastric bypass was the most common procedure.

Abstract

BACKGROUND: Structured dietary management before and after bariatric and metabolic surgery is essential for reducing early postoperative complications, yet evidence describing tolerance and clinical outcomes across different surgical techniques remains limited. This study evaluated a standardized preoperative preparation diet and a uniform postoperative consistency-progression protocol implemented over two decades in a high-volume reference center. METHODS: This retrospective cohort included 622 adult patients who underwent Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), ileal interposition, SADI-S, or gastric bipartition between 2004 and 2024. All patients completed a 10-day anti-inflammatory preoperative diet followed by a two-stage liquid regimen. Postoperatively, patients followed a structured progression from liquid to pureed and finally to solid foods over 30 days. Early outcomes included gastrointestinal symptoms and the occurrence of fistulas or drain use. RESULTS: The cohort comprised 66.9% women, with RYGB being the most frequent procedure (55.5%), followed by SG (24.4%), ileal interposition (14.0%), SADI-S (3.9%), and bipartition (2.3%). Overall prevalence in the first postoperative month was 9.0% for constipation, 2.7% for diarrhea, 8.8% for vomiting, 2.4% for nausea, 0.6% for reflux, and 0.2% for dumping. Fistulas and drain requirements each occurred in 0.5% of patients. Across techniques, 79.9% of patients remained symptom-free; ileal interposition showed the highest symptom rate (29.9%). CONCLUSIONS: A uniform progression protocol following a structured preoperative diet was associated with low rates of gastrointestinal symptoms and postoperative complications across multiple bariatric procedures. These findings suggest that a physiology-based dietary pathway may be safely implemented during early postoperative recovery. Larger prospective studies are warranted, particularly for emerging ileal techniques.

Ask AI

Helpful

Bookmark

View Full Paper