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

Chynoweth, J.; Sorrell, L.; Neilens, H.; MacCormick, A.; Allgar, V.; Aspinall, PJ.; Parkin, T.; Murphy, P.; Takhar, AS.; Fenwick, SW.; Frampton, AE.; Dhakshinammorthy, V.; Puckett, M.; Aroori, S.

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

All Authors

Chynoweth, J.

Sorrell, L.

Neilens, H.

MacCormick, A.

Allgar, V.

Aspinall, PJ.

Parkin, T.

Murphy, P.

Takhar, AS.

Fenwick, SW.

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LTHT Author

Dhakshinammorthy, Vijayanad

LTHT Department

Abdominal Medicine & Surgery
Liver Transplant
Hepatobiliary Surgery

Publication Date

2026

Item Type

Journal Article Randomized Controlled Trial Multicenter Study

Subject

LIVER DISEASES , LIVER NEOPLASMS , NEOPLASM METASTASIS , LIVER , DIET, FOOD, AND NUTRITION

Abstract

BACKGROUND: 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). METHODS: 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. RESULTS: 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. DISCUSSION: 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. TRIAL REGISTRATION: ISRCTN Number 19701345. Date registered: 20/032023. URL: https://www.isrctn.com/ISRCTN19701345.