A pre-operative two-week very low-calorie diet to reduce steatosis before liver resection (RESOLVE): A multi-centre...

Liver surgery (LS) remains the main curative option for liver metastases and primary liver tumours. Low-calorie and very low-calorie diets (VLCDs) are routinely used for 2-4 weeks prior to bariatric and gallbladder surgery to reduce liver size and abdominal adiposity, thereby improving surgical safety. This study aimed to evaluate the feasibility of a VLCD in patients undergoing LS with hepatic steatosis (HS).

In this randomised controlled feasibility trial, 29 participants were randomised to either the intervention group (VLCD providing 800 kcal and 80 g protein for 2 weeks before LS; n = 14) or treatment as usual (n = 15). Feasibility and clinical outcomes, including operating time, blood loss, ease of surgery, length of hospital stay, readmission and mortality, were assessed.

There was no indication of a between-group difference. There was no mortality within 90 days. In the intervention group, 11 participants initiated VLCD and 6 adhered to it for at least 10 days.

Although this feasibility study did not demonstrate a clinical benefit due to the small sample size, a definitive trial is needed to evaluate whether a VLCD administered 2 weeks before LS reduces HS during the preoperative period.

ISRCTN Number 19701345. Date registered: 20/032023. URL: https://www.isrctn.com/ISRCTN19701345.