The rationale for this study is to evaluate whether a standardized, preoperative, short-term Low Calorie Diet (LCD) reduces intraoperative bleeding and postoperative morbidity in liver surgery.
Participants with a BMI of 30 or higher, scheduled for liver surgery, if accepting participation, will be randomized to a 7 day LCD or no intervention.
A previous small single center RCT have shown significantly reduced intraoperative blood loss and a tendency towards less postoperative complications. This multi-centre study aims to include enough patients with power to analyze also postoperative complications.
Scheduled for open or minimally invasive liver resection
BMI ≥30
Diagnosed liver cirrhosis
Perihilar tumours
Inability to understand written information in Swedish, Norwegian, Danish, or English
Parallel
Low calorie meal replacement plan
Dietary supplementShort-term LCD one week prio to liver surgery for patients with a BMI 30 or higher
Postoperative complications
To investigate whether a 7-day preoperative LCD reduces postoperative complications as measured by the Comprehensive Complication Index (CCI). CCI=0 means no complications and CCI=100 means death.
Bleeding
Total intraoperative bleeding measured in millilitres
Operating time
To investigate whether there is a difference in in total operating time measured in minutes including liver mobilisation and parenchymal dissection time specified.
Length of hospital stay (LOS - from the day of surgery until discharge from the hospital)
To compare LOS measured in days between the groups
Radical resection (R0)
Investigate if there is a difference in R0 between the intervention and control group. R0 defined as \>1 mm tumor free margins.
Health-related quality of life (QoL)
Health-related QoL measured by QLQ-C30
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