A survey of the nutritional state of surgical patients using haematological and biochemical measurements has demonstrated a higher frequency of abnormal values in patients following major surgery. Anthropometrtc measurements in patients did not differ from non-hospitalised controls. The routine use of multi-channel biochemical analysls to estimate plasma albumin, and the estlrnation of haernoglobin levels are of value in the postoperative management of surgical patients. Consideration of early intravenous feeding should be given to those patients who do not make a rapid recovery from major surgery.
The dissolving effect of four bile salt solutions (sodium cholate, sodium taurocholate, sodium deoxycholate and sodium chenodeoxycholate) upon gallstones was tested in an in-vitro preparation, using 226 stones f r o m 38 patients. T h e effect of each solution was measured by recording weight loss in the gallstone a t the end of a ten-day period of immersion in the bile salt solution. Sodium deoxycholate and sodium chenodeoxycholate produced the greatest average weight loss i n the groups of stones tested w i t h pure bile salt solutions, but the addition of heparin t o solutions o f sodium cholate and sodium deoxycholate produced a significant increase in weight loss in these solutions. This effect of heparin in the presence of bile salts, in comparison with the failure of heparinized saline t o induce weight loss in gallstones, is discussed. Sodium chenodeoxycholate cannot be recommended f o r clinical use on the grounds of i t s toxicity, and in view of the possible toxicity of sodium deoxycholate it is concluded t h a t a combination of sodium cholate w i t h heparin is the optimum solution f o r the dissolution of retained intraduct calculi in vivo.
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