Internal Biliary Drainage, Parenteral Nutrition, and Variation in the Total Parenteral Nutrition Feeding Solutions: Influence on the Healing of Colon Anastomosis in Jaundiced Rats

Delemarre, J. B. V. M.; Velde, Cornelis J.H. van de; Brauw, L. M. de; Vree, R.; Giesberts, M. A. H.; Hermans, J.

doi:10.1177/0148607190014006629

Cited by 7 publications

(3 citation statements)

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“…The findings seem readily explainable, as TPN is well known to precipitate cholestasis, both clinically and experimentally [14,15]. However, no precipitation or even an improvement in liver function bas been reported in jaundiced humans or rats receiving TPN [12,13]. The contradictory findings may be due to concomitant external or internal biliary drainage in the latter reports; no drainage procedures were performed in our study.…”

Section: Discussionmentioning

confidence: 50%

“…However, in the presence of mainutrition, the route of nutritional support becomes less important than some previous reports suggest [27,28]. Jaundiced subjects fail to ingest adequate oral diet, so the role of TPN becomes important in alleviating malnutrition and its associated complications, irrespective of the side effects of TPN [12,13]. The adverse effect of fat emulsion on the reticuloendothelial system function and its subsequent associated infectious complications [29,30] were not observed in this study.…”

Section: Discussionmentioning

confidence: 50%

“…Total parenteral nutrition (TPN) is frequently an integral part of treating biliary surgery patients with various complications such as wound dehiscence and bile leakage and is effective in Offprint requests: J-H. Chuang, M.D., Division of Pediatric Surgery, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan, Republic of China. alleviating jaundice-associated malnutrition [12,13]. However, TPN is known to precipitate cholestasis and to promote BT [14][15][16].…”

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confidence: 99%

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Role of parenteral nutrition in preventing malnutrition and decreasing bacterial translocation to liver in obstructive jaundice

et al. 1993

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Surgery in patients with obstructive jaundice is associated with significant infectious complications probably due to impaired immune function and malnutrition. Total parenteral nutrition (TPN) may alleviate malnutrition but may also promote bacterial translocation (BT) from the gut. To elucidate if TPN can prevent malnutrition without promotion of BT in obstructive jaundice, 40 dogs underwent laparotomy for tissue sampling and placement of a central venous line and were allocated into one of four groups: I (PO-control) received dog chow and water ad libitum; II (PO-CBDL) underwent ligation of common bile duct (CBDL) and was fed dog chow; III (TPN-control) received TPN; and IV (TPN-CBDL) underwent CBDL and received TPN. Body weight, blood samples for liver function tests and bacterial culture, and tissues from liver and mesenteric lymph nodes (MLN) for quantitative bacterial culture and for histology were obtained prior to and 2 weeks after the experiment. The incidence of BT to MLN was 40% in the PO-CBDL and TPN-CBDL animals, which was significantly different from the other two groups (0%; p < 0.05). The incidence of BT to liver was 70% (7/10) in the PO-CBDL animals, which was significantly higher than that in groups I, III, and IV (0%, 20%, 20%, respectively) (p < 0.05). The PO-CBDL animals showed a significant decrease in body weight and prealbumin compatible with malnutrition, whereas the TPN-CBDL animals showed a significant increase in alkaline phosphatase and a consistent cholestasis on histology. The data suggest that TPN can prevent jaundice-associated malnutrition and decrease BT to liver but should be administered cautiously because it may precipitate cholestasis.

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