Combined Dietotherapy after Extensive Hepatectomies
Objective: to compare the time course of nutritional changes in relation to the components of nutritive support in the early postoperative period after extensive hepatectomies. Subjects and methods. Beginning with the 1st postoperative day, 12 patients had parenteral feeding comprising 20% glucose, fat emulsions, and specialized amino acid solutions (Group 1). Beginning with the same day, 14 patients were given the parenteral formula Oliclinomel (Group 2). Starting from the 2nd postoperative day, both groups additionally received a balanced feeding formula by sipping. Results. Postoperatively, first-to-second degree encephalopathy was recorded in both groups. Positive changes as consciousness recovery were found in both Group 1 in which the patients used branched-chain amino acid-enriched solutions and Group 2 (parenteral Oliclinomel feeding). The patients under examination were not given albumin solutions and fresh frozen plasma in the postoperative period. Moreover, by postoperative day 7, there were significant increases in the levels of albumin and total protein in Groups 1 and 2, in those of cholinesterase and the absolute count of lymphocytes, and a reduction in the concentration of C-reactive protein. Conclusion. Combined parenteral and enteral feedings are effective in patients after extensive hepatectomies. The parenteral feeding formula Oliclinomel may be used in this group of patients.