Ketogenic Diet: 4-week preoperative well-formulated very low carbohydrate isocaloric diet consisting of 50g net daily carbohydrates and 1.5g/kg protein with the remaining energy needs consisting of primarily mono- and polyunsaturated fats
Study summary
Non-alcoholic fatty liver disease is becoming increasingly common in Canada and throughout the world. Fatty liver can increase the risks of perioperative complications for those who need liver surgery. A ketogenic diet is low in carbohydrates and can be very effective in reducing liver fat content. The purpose of this randomized control trial is to compare the effect of a short duration (4 week) preoperative ketogenic diet on operative and disease outcomes in patients undergoing liver surgery. One arm will be randomized to the ketogenic diet and the other will receive standard of care pre-operative dietary consultation.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Patients 18 years of age or older undergoing any type of liver resection (e.g. wedge, formal hepatectomy), either open or laparoscopic, for colorectal liver metastases (CRLM)
* Patients with evidence of hepatic steatosis on pre-operative imaging (CT or MR) or biopsy.
* Ability to use an app based nutritional program to track macronutrient uptake throughout the dietary intervention.
Exclusion Criteria:
* Patients undergoing liver resection for any other indication
* Patients on sodium glucose co-transporter 2 (SGLT-2) inhibitors (these are contraindicated with a ketogenic diet).
* Patients without evidence of hepatic steatosis.
* Patients with evidence of liver fibrosis or cirrhosis on preoperative bloodwork or imaging.
* Patients with alcohol-related hepatic steatosis.
* Patients with a known bleeding disorder.
Primary outcome measure(s)
Perioperative blood transfusion — postoperative days 0-7 receipt (binary) of packed red blood cell (pRBC) units intraoperatively and during the immediate postoperative time period (POD 0 - 7)
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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