J.Jpn. Surg. Soc.. 111(1): 23-26, 2010

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Feature topic

NUTRITIONAL SUPPORT AFTER HEPATIC SURGERY

The liver is very important in maintaining the metabolism of the body and plays a pivotal role in integrating several biochemical pathways for carbohydrates, fat, protein, and vitamins. It is crucial to determine the nutritional status of the patient and provide adequate nutritional support during all phases of hepatic surgery. Progressive deterioration of nutritional status has been associated with a poor outcome of hepatic surgery. Postoperatively, patients should receive an early normal diet or enteral nutrition regardless of the type of hepatic surgery. Patients who receive early enteral nutrition have fewer postoperative infections and better nitrogen retention. Postoperative enteral nutrition yields superior results to the infusion of fluid and electrolytes alone. An energy intake of 35-40kcal/kg body weight/day and a protein intake of 1.2-1.5g/kg body weight/day are recommended. In the long term, the introduction of a late evening snack can contribute to the maintenance of appropriate nutrition and prevent several metabolic complications such as obesity even with the occurrence of fatty liver.

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