Effectiveness of ω-3 Polyunsaturated Fatty Acids Based Lipid Emulsions for Treatment of Patients after Hepatectomy: A Prospective Clinical Trial.
OBJECTIVE
The present study aimed to investigate the effectiveness of parenteral nutritional support with ω-3 PUFAs-based lipid emulsions in patients after liver resection.


METHODS
A total of 119 patients were randomly assigned to the immunonutrition (IM) group (n = 59) and control group (n = 60). The IM group was continuously given Omegaven(®) 10% 100 mL/day rather than regular nutrition for five days postoperatively. Venous blood samples were obtained from all subjects before surgery and D1, D3 and D7 after surgery.


RESULTS
No significant difference was found in baseline characteristics of the two groups. On D1 after surgery, no statistically significant differences were observed in the blood sample tests between the two groups. On D3 after surgery, the levels of white blood cell count (WBC), alanine aminotransferase (ALT), aspartate transaminase (AST) and total bilirubin (TBil) were dramatically decreased in the IM group (t = 3.065, p = 0.003; t = 2.149, p = 0.034; t = 5.313, p= 0.001; and t = 2.419, p = 0.017, respectively). Furthermore, on D7 after surgery, not only could a significant decrease be observed in the IM group concerning the levels of WBC, ALT and TBil (t = 3.025, p = 0.003; t = 2.094, p = 0.038; and t = 2.046, p = 0.043, respectively), but it was also seen in the level of Δprothrombintime (PT) (t = 2.450, p = 0.016). An increase in the level of prealbumin (Pre-Alb) in the IM group was observed on D7 after surgery (t = 2.237, p = 0.027). The frequency of total complications in the IM group were significantly lower than in the control group (χ² = 4.225, p = 0.040 and χ² = 3.174, p = 0.075). The trend favored the IM group in reducing the total infective complications rate (χ² = 3.174, p = 0.075). A significant decrease in the duration of the hospital stay after surgery was also observed in the IM group (t = 2.012, p = 0.047).


CONCLUSIONS
ω-3 PUFAs-based lipid emulsions for treatment of patients after hepatectomy are safe and effective in controlling inflammation, protecting liver function, and consequently reducing the rate of total complications and the duration of the hospital stay.
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. medgongyf@126.com.
Yuanfeng
Y
Gong
Department of Anesthesiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou 061000, China. zhaohuiliu666@hotmail.com.
Zhaohui
Z
Liu
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. chenrf10@gmail.com.
Yadi
Y
Liao
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. medmaic@126.com.
Cong
C
Mai
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. medchentj@126.com.
Tiejun
T
Chen
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. lzhzsdxsyx@gmail.com.
Hui
H
Tang
Department of Hepatobiliary Surgery, the Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China. medtangyq@126.com.
Yunqiang
Y
Tang
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010288:Parenteral Nutrition; D011182:Postoperative Care; D011446:Prospective Studies; D011516:Prothrombin / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D014280:Triglycerides / Q000097:blood
D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D012709:Serum Albumin; D014280:Triglycerides; D011516:Prothrombin; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin
Lipid emulsion; fish oil; hepatectomy; n-3 PUFAs; parenteral nutrition