149 The Safety, Tolerability, and Clinical Impact of Preoperative Very Low-Calorie Diet Before Non-Bariatric Abdominal Surgery: A Systematic Review

Abstract Introduction The use of a very low-calorie diet (VLCD) is established within bariatric and gallbladder surgery. However, their use in patients with a high body mass index (BMI) and hepatic steatosis (HS) who require upper abdominal procedures is unclear. This systematic review aims to review the literature on this subject. Method A systematic search was performed, and studies were included if they administered a VLCD to patients undergoing non-bariatric elective surgery and reported on outcomes. Eight studies were included in this review. Results The VLCD significantly reduced HS, resulting in a less technically complicated operation with reduced intra-operative blood loss. There was no significant impact on intraoperative or early postoperative outcomes. VLCD can be administered safely during the preoperative period, and overall adherence is excellent. There was an overall positive impact on reducing hepatic steatosis, operative difficulty, and intraoperative blood loss. Conclusions VLCDs are established within bariatric and gallbladder surgery, but their use in patients with high BMI and hepatic steatosis requiring other surgery is unclear. The use of a VLCD significantly reduced hepatic steatosis and resulted in a less technically complicated operation with reduced intraoperative blood loss. No significant impact was shown on other intraoperative or early postoperative outcomes.