Objective:

To describe the early clinical outcomes associated with the implementation of a standardized dietary pathway in bariatric and ileal procedures, specifically focusing on gastrointestinal symptoms and complications within the first 30 postoperative days.

Approach:

• Study Design and Setting: Retrospective cohort study conducted at a high-volume bariatric and metabolic surgery reference center, analyzing data from 1,000 adults who underwent procedures between January 2004 and December 2024.
• Participants: 622 patients were included in the analytical cohort after excluding those who did not adhere to the dietary protocol.
• Dietary Protocol: Patients followed a 10-day preoperative anti-inflammatory diet transitioning to a liquid-pureed diet, followed by a structured postoperative dietary progression.

Key Findings:

• Structured preoperative diets can reduce liver volume and improve metabolic status.
• Postoperative dietary progression aims to minimize complications such as vomiting and nutritional intolerance.
• There is considerable variability among centers regarding pre- and postoperative dietary protocols.

Interpretation:

The study emphasizes the role of standardized dietary protocols in optimizing outcomes following bariatric and metabolic surgery.

Limitations:

• The retrospective nature of the study may introduce bias.
• Exclusion of patients who did not adhere to dietary protocols may limit generalizability.

Conclusion:

The implementation of a standardized dietary pathway is associated with improved management of postoperative outcomes in bariatric and metabolic surgery.