J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2289KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 85(9): 985-989, 1984

Report on the annual meeting

NUTRITIONAL MANAGEMENT FOR THE PATIENTS WITH CHRRHOSIS AFTER HEPATECTOMY

*) Dept. of Surgery, Chiba University School of Medicine, Chiba, Japan
**) Dept. of Surgery, Kochi Medical School, Nangoku, Japan

Sadahito Usui, Akio Sakamoto, Kazuma Yamazaki, Nobuyuki Tokumoto, Soketsu Shu, Isao Kawamura, Munemasa Ryu, Michio Odaka, Hiroshi Sato*), Shohei Ogoshi**)

Nutritional management for the patients with cirrhosis after hepatectomy was studied. Based on the experimental results, 1-1.5g/kg/day of branched chain amino acid (BCAA) enriched solution with 30 kcal/kg/day of glucone was given to the cirrhotic patients after hepatectomy for 10-14days. Sodium and total fluid volume were strictly restricted. Elemental diet for liver failure (ED-H) was started to give witihin 7days after surgery for 6-21days.
High relationships were observed between preoperative nutritional status such as prealbumin and retinol binding protein (RBP) and incidence of postoperative complications, suggesting that postoperative nutritional supply was very important.
Changes of albumin, hepaplastin test and prothrombin time were rather good and the BCAA to aromatic amino acids molar ratio was maintained high when nutritional management was performed.
Overall one and two year survival rates were 74 % (20/27) and 36 % (5/14), respectively. No significant difference was seen between the prognoses of the patients with and without liver dysfunction. Immediate postoperative nutritional management must be essential to get over critical stage safely and long-term nutritional supply may be necessary to get better prognosis.

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