147 A Pre-Operative Two-Week Very Low-Calorie Diet to Reduce Steatosis Before Liver Resection (RESOLVE): A Multi-Centre Randomised Controlled Feasibility Trial

Abstract Background Liver surgery remains the main curative option for liver metastases and primary liver tumours and offers a clear survival benefit. Low-calorie and very low-calorie diets are routinely used 2-4 weeks before bariatric and gallbladder surgery to reduce liver size and abdominal adiposity, thereby increasing operative visualisation. This study aimed to evaluate the feasibility of a very low-calorie diet in patients undergoing liver surgery with hepatic steatosis defined by magnetic resonance imaging. Method In this feasibility study, a total of 29 participants were randomised (age mean (standard deviation): 60.5 (11.2) years) to either the intervention group: a very low-calorie diet providing 800kcals and 80g protein for 2 weeks before liver surgery (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 in favour of the intervention group for the clinical outcome measures. There was no mortality within 90 days in this study. In the intervention group, 11 (78.6%) participants implemented the very low-calorie diet for at least one day, and 6 (42.9%) adhered to it for at least 10 days. Conclusions This feasibility study encountered challenges in patient recruitment. Although this small sample size did not reveal a clinical benefit, a future definitive trial is needed to evaluate whether a very-low-calorie diet 2 weeks before surgery can reduce hepatic steatosis during the preoperative period.