RESOLVE is a NIHR funded feasibility Randomised Controlled Trial developed to investigate the effects of a two-week very low-calorie diet (VLCD) plus dietetic support intervention for patients with hepatic steatosis (HS) before elective liver surgery (LS). The study is led by Mr Somaiah Aroori (Consultant Hepatico Pancreato Biliary & Transplant Surgeon) and Professor Victoria Allgar (Professor of Medical Statistics and Director of PenCTU). The study is managed by the Peninsula Clinical Trials Unit.
Hepatic steatosis (fatty liver) is now the most common liver disorder affecting between 20-50% of the Western population. HS increases morbidity and mortality associated with LS. The morbidity rates of LS range from 22-62% in the presence of steatosis compared to 8-35% in patients without steatosis. Reported mortality for LS in patients with moderate to severe steatosis is 14% compared with 3% in patients without steatosis. Furthermore, patients with steatosis are more likely to require a blood transfusion, which is associated with worse short- and long-term outcomes.
At present, patients with HS requiring LS receive no specific dietary treatment or advice. VLCD is commonly used for 2-12 weeks before gallbladder and bariatric surgery to reduce liver volumes and reduce associated intraoperative morbidity. However, there is a lack of scientific evidence on whether these diets would be useful in patients with HS undergoing LS.