[Significance of perioperative nutritional support and activation of the reticuloendothelial system on the resection of the cirrhotic liver].
The cirrhotic patients were in poor nutritional condition and deteriorated reticuloendothelial function, which were further aggravated after hepatic resection. Preoperative nutritional repletion treatment as well as preoperative administration of OK-432 improved the nutritional condition and reticuloendothelial function of the patients, resulting in uneventful postoperative courses. In experimentally induced liver cirrhosis, however, an excessive amount of glucose administration in the early postoperative period induced the reduction of hepatic energy charge and ATP content. An adequate amount of glucose should be administered in a period associated with marked glucose intolerance. To determine daily glucose disposal rate rapidly, blood glucose curve obtained from intravenous glucose tolerance test (IVGTT) and insulin tolerance test (ITT) was analyzed in hepatectomized cirrhotic rats. It was possible to calculate prospected values of glucose disposal rate by the analytic index of IVGTT and ITT. An adequate perioperative nutritional support and the activation of the reticuloendothelial system are thought to have important therapeutic value to prevent complications of liver cirrhosis after resection.
Ouchi
K
K
First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Sakai
K
K
Sato
R
R
Nakagawa
K
K
Matsuno
S
S
Sato
T
T
D000818:Animals; D005947:Glucose / Q000008:administration & dosage; D005951:Glucose Tolerance Test; D006498:Hepatectomy; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000601:surgery*; D008106:Liver Cirrhosis, Experimental / Q000601:surgery; D008297:Male; D012157:Mononuclear Phagocyte System / Q000503:physiopathology*; D010844:Picibanil / Q000008:administration & dosage / Q000627:therapeutic use; D011300:Preoperative Care; D051381:Rats; D011919:Rats, Inbred Strains
D007328:Insulin; D010844:Picibanil; D005947:Glucose