Perioperative Nutritional Support in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

Abstract

Perioperative nutritional support can reduce complications after major hepatectomy for hepatocellular carcinoma associated with cirrhosis.

Role of Supportive Care for Terminal Stage Hepatocellular Carcinoma

“…One trial of parenteral nutrition 53 and five of supplements [54][55][56][57][58] included patients with hepatocellular carcinoma. The current data do not compellingly justify the routine use of parenteral nutrition, enteral nutrition, or oral nutritional supplements in these patients.…”

Parenteral Solution of Nutritional Hepatotrophic Factors Improves Regeneration in Thioacetamide-induced Cirrhotic Livers after Partial Hepatectomy

“…Thus, providing nutritional support for patients with cirrhosis may prevent progressive liver failure, reduce mortality, and improve their quality of life (Merli et al 2002;Bianchi et al 2008;Urata et al 2007;Holeck 1999). In subjects undergoing major hepatic resection or surgery, the correction of malnutrition and the prevention of weight loss may reduce mortality, both prior to the surgical procedure and following the surgical procedure (Bianchi et al 2008;Fan et al 1994). It is important to provide metabolic support for the remnant liver during the early period after PH (Hashimoto and Watanabe 1999); the NHF solution may enrich the portal blood with nutrients that are diminished during cirrhosis, and it can also stimulate liver regeneration.…”

Early recovery pathway for hepatectomy: data-driven liver resection care and recovery

“…In fact, there is relatively weak evidence to support the practice of carbohydrate loading in advance of surgery, but afterward it is clear that early introduction of enteral nutrition can reduce overall morbidity and specifically septic complications (39)(40)(41)(42). Following hepatic resections, patients are in a catabolic state characterized by glucose and electrolyte imbalances mitigated by increased metabolic demand (43).…”