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Preoperative carbohydrate loading: evolution, trends, and future directions.

Shuxia Liu1, Qiaolan Liu1, Yan Zhu1

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|March 27, 2026
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Summary
This summary is machine-generated.

Preoperative carbohydrate loading (PCL) improves metabolic homeostasis and reduces surgical stress. This bibliometric analysis reveals research trends and identifies gaps in personalized clinical nutrition practices for PCL.

Keywords:
Enhanced recovery after surgeryInsulinresistanceManagementPreoperative carbohydrate loadingbibliometric analysis

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Area of Science:

  • Nutrition Science
  • Metabolic Research
  • Surgical Perioperative Care

Background:

  • Preoperative carbohydrate loading (PCL) is a clinical strategy to mitigate the catabolic effects of surgical fasting by improving insulin sensitivity and metabolic stability.
  • Existing literature lacks a comprehensive overview of the historical achievements, academic influence, and evolving research landscape of PCL.
  • Understanding publication patterns and research trends is crucial for advancing PCL's application in clinical settings.

Purpose of the Study:

  • To conduct a bibliometric analysis of global research on preoperative carbohydrate loading (PCL).
  • To characterize publication patterns, academic influence, research trends, and recent developments in the field of PCL.
  • To identify key research frontiers and future directions for PCL research and implementation.

Main Methods:

  • A cross-sectional bibliometric analysis was performed using data from the Web of Science Core Collection and PubMed up to March 27, 2025.
  • VOSviewer, Citespace, and SciExplorer were utilized to analyze publication data, including country, institution, author, journal, and keyword contributions.
  • Evaluative indices such as citation counts, journal impact factors, and collaboration metrics were calculated to assess academic influence.

Main Results:

  • A total of 269 publications from 38 countries/regions, involving 1,478 authors and 439 institutions, were identified, alongside 141 clinical trials.
  • China leads in publication volume, while England shows high centrality and international collaboration; Olle Ljungqvist is identified as a key contributor.
  • Prominent research topics include metabolic responses, recovery and clinical outcomes, preoperative management, and research techniques, with four distinct research frontiers identified.

Conclusions:

  • Research on PCL has evolved from physiological validation to integration within Enhanced Recovery After Surgery (ERAS) protocols.
  • Gaps persist in translating PCL evidence into personalized, harmonized, and technologically supported clinical nutrition practices.
  • Future efforts should focus on tailoring PCL to individual patient factors, integrating harmonized outcomes and technology, and fostering multidisciplinary collaboration.