[Postoperative total parenteral nutrition with fat emulsion for patients with esophageal varices]

The administration of fat emulsion and total parenteral nutrition (TPN) was evaluated in 68 patients with liver disorders who underwent surgical treatment for esophageal varices. The subjects were divided into two groups, fat group (28 cases) and non-fat group (40 cases) according to with or without the administration of fat emulsion during the period of postoperative TPN. The results of liver function tests, blood glucose levels, intravenous fat tolerance tests, serum lipid levels, fatty acid composition in serum total lipids, nitrogen balances and body weight changes during the period of postoperative TPN were compared between both groups. Conclusions as follows; 1. The administration of fat emulsion during the period of postoperative TPN did not worsen the results of liver function tests, and relatively low levels of blood glucose were retained. 2. The removal rates of fat emulsion from the blood (K2 values) during the period of postoperative TPN were significantly higher than in those preoperative period, and changes in serum lipid level revealed no tendency toward retention of fat emulsion administered intravenously. 3. Cumulative nitrogen balance were almost similar in both groups. 4. The administration of fat emulsion the period of during postoperative TPN corrected the abnormalities of fatty acid composition in serum total lipid. Further, it was suggested that approximately more than 5 ml/kg/day of 10% fat emulsion would be advisable to prevent the decrease of linoleic acid. 5. These results suggested that the administration of fat emulsion was useful for the patients with esophageal varices during the period of postoperative TPN.