Preoperative Carbohydrate Loading Benefits in Liver Resection: Study

Findings from a new retrospective analysis suggest that preoperative oral carbohydrate administration reduces insulin resistance and enhances recovery quality in patients undergoing elective laparoscopic liver resection. Researchers observed that patients who received carbohydrates before surgery experienced faster gastrointestinal recovery, lower insulin resistance, reduced inflammation, and improved quality of recovery scores compared to those given only water. The study included 110 patients, divided into a control group (n=55) and a research group (n=55). Both groups received fluids the evening before and 2.5 hours prior to surgery, but the control group consumed distilled water, while the research group received equivalent volumes of carbohydrate solution. Outcomes assessed included blood glucose, insulin levels, insulin resistance index (HOMA-IR), recovery quality (QoR-15), inflammatory and immune markers, and liver function.Results showed clear benefits for the carbohydrate group. These patients reported a significantly lower incidence and severity of postoperative nausea and vomiting. Key recovery milestones, such as time spent in post-anesthesia care, first rectal exhaust, and first feeding, were achieved sooner. Importantly, insulin levels and HOMA-IR values were significantly lower on postoperative days 1 and 3 in the carbohydrate group, indicating better metabolic regulation. The study also highlighted broader recovery improvements. QoR-15 scores, which reflect overall quality of recovery, were consistently higher in the carbohydrate group, with a steady upward trend during the postoperative period. By day 3, inflammatory markers and liver function indicators were lower, while immune cell markers were elevated, suggesting enhanced immune recovery. Statistical analyses confirmed a positive correlation between preoperative carbohydrate intake, improved insulin sensitivity, and recovery outcomes. According to the authors, preoperative carbohydrate loading represents a simple, safe, and effective strategy to optimize surgical outcomes in laparoscopic liver resection patients. By minimizing insulin resistance and supporting immune and metabolic balance, carbohydrate administration could become an important component of enhanced recovery protocols.

Keywords: preoperative carbohydrate loading, insulin resistance, laparoscopic liver resection, recovery quality, HOMA-IR, QoR-15