Oral carbohydrate intake before selective laparoscopic liver resection reduces insulin resistance and enhances recovery.

Abstract

Objective: To investigate the effects of preoperative oral carbohydrate administration on insulin resistance and recovery quality in patients undergoing selective laparoscopic liver resection.

Methods: Data from 110 patients were retrospectively analyzed, and divided into a control group (n=55) and a research group (n=55). The control group received 800 mL of distilled water at 20:00 the evening before surgery, and 400 mL 2.5 hours before surgery. The research group received the same volume of carbohydrates at the same time points. Differences in blood glucose, insulin levels, insulin resistance (HOMA-IR), recovery quality (QoR-15), inflammatory and immune cell markers, and liver function were compared. Spearman correlation and logistic regression analyses were performed to explore the relationship between carbohydrate intake and recovery.

Results: The research group had significantly lower incidence and severity of nausea and vomiting compared to the control group (χ²=0.037, χ²=0.030, both P<0.05). Postoperative recovery times, including post-anesthesia care, first rectal exhaust, and first feeding, were shorter in the research group (t=0.034, 0.021, 2.832, all P<0.05). Insulin levels and HOMA-IR were lower on postoperative days 1 and 3 in the research group (both P<0.05). QoR-15 scores were higher in the research group (F=100.100, P<0.001), showing an increasing trend over time (F=22.130, P<0.001). On day 3, inflammatory and liver function markers were lower in the research group, while immune cell markers were elevated (all P<0.05). Preoperative carbohydrate intake correlated with improved insulin sensitivity and recovery quality (P<0.05).

Conclusion: Preoperative oral carbohydrate administration reduces insulin resistance, enhances recovery, and improves postoperative rehabilitation quality in patients undergoing elective laparoscopic liver resection.