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Related Experiment Videos

Nutritional support after open liver resection: a systematic review.

B Richter1, T C Schmandra, M Golling

  • 1Department of Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.

Digestive Surgery
|July 1, 2006
PubMed
Summary

Early enteral nutrition after liver resection is safe and reduces postoperative complications like infections. This approach improves immune function compared to parenteral nutrition, though mortality rates remain similar. Further multicenter trials are needed to confirm these findings.

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Nutrition
  • Gastroenterology

Background:

  • Perioperative nutrition for patients with impaired liver function post-resection is debated.
  • The role of total enteral nutrition in this context is not fully established.
  • Limited liver function after partial hepatectomy necessitates careful nutritional management.

Purpose of the Study:

  • To evaluate the impact of early postoperative total enteral nutrition on patient recovery after partial liver resection.
  • To compare the efficacy of enteral nutrition versus parenteral nutrition in the perioperative period.

Main Methods:

  • Systematic review of five prospective, randomized controlled trials (1960-2005).
  • Medline database search for studies comparing enteral and parenteral nutrition post-liver resection.

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  • Analysis of primary endpoints including complication rates (infection, organ malfunction) and mortality, alongside immune parameters.

    • Main Results:

    • Enteral nutrition significantly reduced wound infections and catheter-related complications (p=0.04) compared to parenteral nutrition.
    • No significant difference in mortality was observed between the two nutritional strategies.
    • Patients receiving enteral nutrition demonstrated enhanced postoperative immune competence.

    Conclusions:

    • Early enteral nutrition is a safe strategy following liver resection.
    • It is associated with a lower incidence of postoperative complications compared to parenteral nutrition.
    • Further high-quality, multicenter randomized controlled trials are warranted to refine nutritional protocols and confirm benefits.