Korean J Hepatobiliary Pancreat Surg.  2012 Nov;16(4):129-133. 10.14701/kjhbps.2012.16.4.129.

Effect of early enteral nutrition after hepatectomy in hepatocellular carcinoma patients

• Lee J
• Kwon CH
• Kim JM
• Shin M
• Joh JW

• KMID: 2243189
• DOI: http://doi.org/10.14701/kjhbps.2012.16.4.129

Abstract

BACKGROUNDS/AIMS
To evaluate the effect of early enteral nutrition after hepatectomy in hepatocellular carcinoma (HCC) patients on postoperative gastrointestinal motility recovery and admission days, liver function and nutrition recovery, and postoperative complication.
METHODS
From August 2010 to July 2011, 102 patients with primary HCC underwent hepatectomy. Forty two patients took a sip of water (SOW) at postoperative day (POD)#1, soft blended diet (SBD) at POD#2 (early diet group, ED group), otherwise 60 patients took a SOW at POD#3, SBD at POD#4 (conventional diet group, CD group). Postoperative flatus-pass day, stool-pass day, nausea, vomiting, admission days, immediate postoperative (POD#0) and POD#1, 3, 5, 7 profiles of albumin, prothrombin time (PT) INR, total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), white blood cell (WBC), and POD#1, 3, 5, 7 profiles of C-reactive protein (CRP), and postoperative complications cases were compared between ED group and CD group. All clinical data were compared retrospectively.
RESULTS
Flatus-pass days (p<0.01), stool-pass days (p<0.01) and postoperative admission days (p=0.012) were shorter in ED group. Total bilirubin levels were higher at POD#0, 1, 3 but lower or similar at POD#5, 7 in ED group. AST, ALT levels were higher at POD#0 but lower at POD#1, 3, 5. There were no significant differences in albumin, PT INR, WBC, CRP and postoperative complication rates.
CONCLUSIONS
ED group had no difference in nutritional recovery and postoperative complication rates compared to CD group but it has better gastrointestinal motility recovery, liver function recovery, and shorter postoperative admission days.

Keyword

Early recovery after surgery; Early diet; Gastrointestinal motility; Liver function; Postoperative admission days

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
C-Reactive Protein
Carcinoma, Hepatocellular
Diet
Enteral Nutrition
Gastrointestinal Motility
Hepatectomy
Humans
International Normalized Ratio
Leukocytes
Liver
Nausea
Postoperative Complications
Prothrombin Time
Recovery of Function
Vomiting
Water
Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
C-Reactive Protein
Water

Figure

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  Fig. 1 Comparison of total bilirubin level between early diet (ED) group and conventional diet (CD) group. POD, postoperative days.

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  Fig. 2 Comparison of alanine aminotransferase (ALT) level between early diet (ED) group and conventional diet (CD) group. POD, postoperative days.

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