the potential role of fish oil/ω-3 polyunsaturated fatty acids supplementation on liver size before bariatric surgery

Background: an enlarged liver, resulting from fatty liver and or steatohepatitis, may cause complications in gastric bypass surgery and increase the risk of liver laceration. recently, ω-3 polyunsaturated fatty acids (ω-3 pufas) have been suggested as a potential intervention to reduce liver inflammation and volume. this review aimed to provide a comprehensive overview of the recent advances on fish oil/ ω-3 pufas supplementation to reduce the liver volume before the bariatric surgery. methods and materials: this review summarizes studies investigating the influence of fish oil/ ω-3 pufa in the liver volume of bariatric surgery candidates. scopus and pubmed databases were systematically searched up to may 2021 for studies providing knowledge about the effects of ω-3 and or fish oil supplementation on liver size, fatty liver, or steatohepatitis. results: most randomized controlled trials showed that ω-3 pufa supplementation, primarily due to its anti-inflammatory and antioxidative properties, is a practical and effective treatment for fatty liver. it also decreases alanine transaminase (alt), aspartate transaminase (ast), and gamma-glutamyl transferase (ggt). ω-3 fatty acids as essential regulators of hepatic gene transcription can reduce hepatic steatosis and inflammation markers; they also improve insulin sensitivity. as well, the access to the gastroesophageal junction was reported as simple. conclusion: the observed data suggest that preoperative fish oil/ω-3 pufa supplementation could effectively improve liver function and decrease liver volume before bariatric surgery. however, well-designed randomized clinical trials are needed to confirm these results and determine a clear supplementation protocol regarding the optimal dose and duration before surgery