J.Jpn. Surg. Soc.. 89(9): 1371-1374, 1988

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Report on the annual meeting

SIGNIFICANCE OF PERIOPERATIVE NUTRITIONAL SUPPORT AND ACTIVATION OF THE RETICULOENDOTHELIAL SYSTEM ON THE RESECTION OF THE CIRRHOTIC LIVER

The cirrhotic patients were in poor nutritional condition and deteriorated reticuloendothelial function, which were further aggravated after hepatic resection. Preoperative nutritinal repletion treatment as well as preoperative administration of OK-432 improved the nutritinal condition and reticuloendothelial functin of the patients, resulting in uneventful postoperative courses. In experimentially induced liver cirrhosis, however, an excessive amount of glucose administration in the early postoperative period induced the reductin of hepatic energy charge and ATP content. An adequate amount of glucose should be administered in a period associated with marked glucose intolerance. To determine daily glucose disposal rate rapidly, blood glucose curve obtained from intravenotis glucose tolerance test (IVGTT) and insulin tolerance test (ITT) was analyzed in hepatectomized cirrhotic rats. It was possible to calculate prospected values of glucose disposal rate by the analytic index of IVGTT and ITT. An adequate perioperative nutritinal support and the activation of the reticuloendothelial system are thought to have important therapeutic value to prevent complications of liver cirrhosis after resection.

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