Evaluation of postoperative nutritional state after hepatectomy for hepatocellular carcinoma.
OBJECTIVE
In spite of many technical advances in liver surgery, optimal nutritional support after hepatectomy has not been established.


METHODS
We clarified the actual nutritional state in 16 patients with total parenteral nutrition (TPN group), and 16 patients without total parenteral nutrition (PPN group), after hepatectomy for hepatocellular carcinoma without biliary tract reconstruction, in terms of preoperative clinical data, intraoperative indexes, postoperative management and complications, liver function data, nutritional state, and changes in metabolic parameters.


RESULTS
There were no significant differences in any occurrences of postoperative complications, liver function data, or nutritional parameters between the two groups. On the other hand, the TPN group needed more doses of insulin than the PPN group. The beginning of each water and food intake was earlier in the PPN group than in the TPN group. The blood glucose level was higher in the TPN group than in the PPN group. The serum sodium and chloride levels were lower, but the serum potassium level was higher, in the TPN group compared to the PPN group. Thus, problems such as hyperglycemia and serum electrolyte abnormalities were more conspicuous in the TPN group than in the PPN group.


CONCLUSIONS
In the actual clinical care after hepatectomy for hepatocellular carcinoma without biliary tract reconstruction, in which oral feeding is started early, total parenteral nutrition is considered unnecessary.
Department of Surgery, Wakayama Rosai Hospital, 435-Koya, Wakayama 640-8505, Japan. hotta@naxnet.or.jp
Tsukasa
T
Hotta
Yasuhito
Y
Kobayashi
Katsutoshi
K
Taniguchi
Kiyofumi
K
Johata
Masaki
M
Sahara
Teiji
T
Naka
Tsunehiro
T
Maeda
Hiroshi
H
Tanimura
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total; D011184:Postoperative Period; D011446:Prospective Studies