A Prospective Study On Early Enteral And Parenteral Nutritional Support On Patients Of Hepatectomy

Objective:To compare early enteral with parenteral nutritional support in patients undergoing liver resection prospectively.Methods:59 patients undergoing hepatectomy in department of hepatobiliary surgery of affiliated hospital of Qingdao University were separated into 2 groups randomly.29 patients were given enteral nutritional(EN) support for 7 days,the remaining 30 ones were assigned to receive parenteral nutritional(PN) support at the same time.There is no significant difference in nutritional status preoperatively or types of liver resection.The investigation of effects of early enteral and parenteral nutritional support in patients undergoing hepatectomy was based on anthropometric measurement, serum biochemical and immunologic assessment.Results:There was no significant difference of every-day intake of calories and nitrogen between the two groups.All patients were tolerant to their nutritional support.At the end of this program,body weight and midarm circumference of the 2 groups had not recover from the effects of operation.At postoperative(PO) day 1,the level of serum total protein,albumin and prealbumin of the 2 groups were declining,and they did not recover until PO day 8 except albumin of EN group,whereas only prealbumin of PN group recovered well.The mean recovery time of bowel open of EN group was 29±12h versus that of PN group 38±14h.The use of albumin volume of PN group was more than EN group's(P=0.048),and the daily expense was higher than EN group's(P＜0.05), which was 344±65 yuan versus 235±46 yuan.Both counts of peripheral blood lymphocyte of the two group recovered well,and there were no significant differences between the two groups.The concentration of serum interleukin-2(IL-2) on PO day 8 of EN group was higher than that before operation,and also higher than that of PN group's at the same time.The concentration of serum interleukin-10(IL-10) on PO day 8 of PN group was lower than that before operation.There were no significantly statistical differences of morbidity and mortality in the hospital between the two groups.Conclusions:The enteral nutritional support has much more advantage than that of PN group's on improvement of post-operative nutritional status and immunologic function,and has lower expense of nutritional support.