Early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization.
BACKGROUND
The abnormal metabolism caused by cirrhosis always results in a complex problem about nutritional support, which will be more intricate while patients with portal hypertension are treated with pericardial devascularization. Comparing the effects of early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization, we try to realize the advantages and disadvantages of the two nutritional therapies and to guide our clinical practice.


METHODS
After pericardial devascularization, 40 patients with cirrhotic portal hypertension were divided randomly into 2 groups: enteral and parenteral nutritional support, respectively. The general nutritional condition, capability of producing protein, liver function, blood velocity of the portal vein, gut function, bowel bacterial translocation, mortality, complication rate, stay in ICU, duration of hospitalization and costs of treatment were determined in all the patients and compared between the 2 groups.


RESULTS
Both enteral and parenteral nutritional supports could improve the general nutrition condition of the patients; but patients receiving enteral nutritional support had fewer complications. Enteral nutrition was more effective than parenteral nutrition in increasing the blood velocity of the portal vein, stimulating gut motion, preventing bowel bacterial translocation, shortening the stay in ICU and the duration of hospitalization, and saving costs of treatment.


CONCLUSIONS
After pericardial devascularization, patients with cirrhotic portal hypertension should be treated with enteral nutritional support as early as possible.
Zhang
Ke
K
Department of Hepatobiliary Surgery, The 302nd Hospital of PLA, Beijing 100039, China. zhangke@sina.com
Sun
Weing-Bing
WB
Wang
Hui-Feng
HF
Li
Zhi-Wei
ZW
Zhang
Xiao-Dong
XD
Wang
Hong-Bo
HB
Ji
Xu
X
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D009852:Omentum / Q000601:surgery; D010288:Parenteral Nutrition / Q000379:methods*; D010496:Pericardium / Q000601:surgery*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome