Preoperative Ketogenic Diet for Reduction of Hepatic Steatosis

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

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.

Conditions6

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