J.Jpn. Surg. Soc.. 62(2): 178-203, 1961

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STUDIES OF NUTRITION IN SURGICAL BILE DUCT DISEASES

The author analysed main factor in oral feeding in 75 cases of surgical bile duct diseases pre-and postoperatively. These cases were divided into two groups- group I. consists of patients who were given a usual hospital diet and group II. consists of patients who were given a special diet containing high protein and high calories. The author gave a nutritional investigation on these cases, especially about digestion and absorption, and obtained the conclusions as follows:
1) The examinations of digestion and absorption had been usually represented in term of absorption rate, but the author expressed that in term of term of g%. That expression was reasonable in the early postoperative stage.
2) In the cases of forced feeding for a week before operation, the patient was taken 30- 72g (average 50g) of fat, 43- 105g (average 72g) of protein, 150- 405g (average 255g) of carbohydrate and 1,400- 2,480 Cal. without side reastions
3) Before operation, there was not a quantitative co-relation between the intake of nutriments and excretion of it and absorption rate in group II. was much better. From this point the forced feeding before operation was proved so effective. The absorption rate before operation was varied according to disease and it was found that the absorption rate in cholangitis and cholecystitis cases was the best, gallstone cases was next, and carcinoma of the bile duct and the head of the pancreas was the worst.
4) The total amount of nutriments taken during a week after operation in group II. contained 219.9g of fat, 325.1g of protein, 1,121.5g of carbohydrate and 7,826 Cal. After the fourth day postoparation, daily intake of 40g or more of fat and 60g or more of protein was possible.
5) The digestion and absorption of fat and protein during a week after operation in group II. was better than that in group I. The author proved that forced feeding of fat and protein in the early postoperative stage was reasonable. Absorption rate of carcinoma after operation was the worst as same as before operation.
6) It was proved that function of the liver and the secretion of the bile would influence digestion and absorption of fat and protein before and after operation.
(Author's abstract)

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