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For other cancer types, ad libitum KD rather than VLCKD is usually best, unless rapid weight loss is advisable for specific reasons. However, fasting related perioperative ketosis seems not to pose at increased risk of acidosis.53 A recent study reports a VLCKD to be interrupted the day before surgery in 44 prebariatric patients, but no safety outcomes are shown.51 Of note, a recent case report showed that the concomitant use of SGLT‐2 inhibitors and VLCKD consumption in a diabetic patient undergoing surgery led to recurrent intraoperative torsade de pointes.24 Moreover, preoperative VLCD has been shown to induce hypovolaemia possibly increasing the risk of perioperative complications in a study including 28 prebariatric patients.52 However, data relative to the treatment intervention and timing are insufficient to draw conclusions on such outcome. 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