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

Authors

• Jade Chynoweth, Peninsula Medical School
• Lexy Sorrell, Peninsula Medical School
• Helen Neilens, University of Plymouth
• Andrew MacCormick, Peninsula Medical School
• Victoria Allgar, Peninsula Medical School
• Paigan J. Aspinall
• Tracey Parkin, School of Health Professions
• Paula Murphy
• Arjun S. Takhar
• Stephen W. Fenwick
• Adam E. Frampton
• Vijayanad Dhakshinammorthy
• Mark Puckett
• Somaiah Aroori, Peninsula Medical School

ORCID

• Jade Chynoweth: 0000-0002-2516-5923
• Lexy Sorrell: 0000-0001-8044-3706
• Andrew MacCormick: 0000-0001-5678-5087
• Victoria Allgar: 0000-0002-5228-2623
• Tracey Parkin: 0000-0002-7081-2253

Abstract

BackgroundLiver 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).MethodsIn 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.ResultsThere 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.DiscussionAlthough 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.

DOI Link

10.1016/j.ejso.2026.111504

Publication Date

2026-01-01

Publication Title

European Journal of Surgical Oncology

Volume

52

Issue

4

ISSN

0748-7983

Acceptance Date

2026-02-23

Deposit Date

2026-03-12

Embargo Period

2027-03-02

Funding

This work was supported by the NIHR Research for Patient Benefit funding scheme—grant number NIHR203632. The authors would like to thank the study participants for their contributions and the NIHR for funding support to the RESOLVE study. They would also like to acknowledge the study sponsor: University Hospitals Plymouth NHS Trust, contact:plh-tr.rdgovernance@nhs.net.

Additional Links

https://doi.org/10.1016/j.ejso.2026.111504

Keywords

Hepatic steatosis, Liver metastases, Liver surgery, Liver tumour, Low-calorie diet

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Chynoweth, J., Sorrell, L., Neilens, H., MacCormick, A., Allgar, V., Aspinall, P., Parkin, T., Murphy, P., Takhar, A., Fenwick, S., Frampton, A., Dhakshinammorthy, V., Puckett, M., & Aroori, S. (2026) 'A pre-operative two-week very low-calorie diet to reduce steatosis before liver resection (RESOLVE): A multi-centre randomised controlled feasibility trial', European Journal of Surgical Oncology, 52(4). Available at: 10.1016/j.ejso.2026.111504