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2 Weeks Before Surgery

3 Rules for the pre-surgery liquid diet:

  1. Stop all solid, soft or pureed foods. 
  2. You may only choose liquids that are listed. No other fluids are allowed.
  3. Your surgery can be delayed if you don’t follow this pre-surgery liquid diet.

Why do you have to do this?

  • This diet is also known as the liver shrinking diet.
  • Your liver needs to shrink to make your surgery safer.
  • You must limit calories and carbohydrate to allow the liver to shrink, your dietitian will give you your specific goals during your consult.
  • There are 3 Steps in the pre-surgery liquid diet.


  • An 8 oz. serving is 1 cup when using measuring cups.
  • If you experience vomiting or diarrhea, contact your dietitian.
  • Continue taking your supplements (multi-supplement, calcium and iron, if prescribed).

Pre-Surgery Liquid Diet: Starts 2 weeks before surgery

Step 1 - Stop ALL solid, soft or pureed foods. Meals and fluids will only consist of the following.

Liquid Meals 

  • High Protein/Low Carbohydrate Protein Shakes should meet program guidelines. 
  • Protein supplements need to have, per 6-12 oz. serving: at least 20-30 grams of protein, less than 5-7 grams of total carbohydrates, and less than 3-5 grams of fat. 
  • The amount of supplements you have will individualized with your dietitian on your visits. You can use ready to drink protein shakes or powdered protein. You will be given specifics of how many shakes you can mix with water, skim or 1% milk, light soy milk, unsweetened or light almond milk. Our goal will be to keep you in a certain calorie and carbohydrate limit.

Water Based Fluids

Choices: Water, plain or flavored. Flavors include Crystal light, MIO, Dasani Water Enhancer, Sugar free Koolaid, or a generic equivalent. Sugar free water Enhancers may have up to 5 calories per serving, and this is allowed.

Optional: Only one 8 oz. decaf tea OR decaf coffee per day in order to promote hydration.

You may not have: Fluids that have caffeine, carbonation or calories. 

How Often: 4-6 servings per day. Drink in between the high protein/low carbohydrate shakes

Serving size: At least 8 oz. An 8 oz. serving is 1 cup when using measuring cups.

Snacks (optional)

  • 8 oz. (1 cup) sugar free gelatin (ex: Jello or generic brand). This is 2 of the pre-made cups per day.
  • 1 or 2 sugar free popsicles per day. Your choice must be 20 calories or less for each popsicle.

You may have one 16oz bottle of sugar free electrolyte beverage such as Propel or Powerade Zero per day.

No broth or soups allowed during this phase. 

No substitutions allowed.