The primary objective of this interventional study is determine if the future liver remnant can be optimized by improving liver function pre-operatively in patients who are scheduled for major hepatectomy. The main questions it aims to answer are:
1. Does high-dose insulin therapy improve liver function in the pre-operative setting? 2. What is the effect of high-dose insulin therapy on liver function and liver regeneration after a liver venous deprivation (LVD) procedure? 3. What is the relationship between volume hypertrophy and function in the regenerating liver? Participants will receive a 6-hour infusion of insulin and dextrose to maintain a hyperinsulinemic-normoglycemic state in the weeks prior to planned liver surgery to assess its effect on liver function measured by 99m-Tc-Mebrofenin hepatobiliary scintigraphy.
Age > 18 years old
Candidate for major liver resection
Resectable colorectal liver metastasis
Inability to give consent
Type 1 diabetes mellitus
Uncontrolled blood glucose levels (fasting level > 10 mmol/L)
Unresectable colorectal liver metastasis
McGill University Health Centre/Research Institute of the McGill University Health Centre
Lead sponsor