The influence of Enteral Nutrition in postoperative patients with poor liver function

Table 1 Grouping of patients

	CON (n = 30)			TPN (n = 40)			EN (n = 65)
	Cases	Grade		Cases	Grade		Cases	Grade
		B	C		B	C		B	C
PVH	13	10	3	14	8	6	21	10	11
HCC	4	2	2	11	7	4	10	5	5
CLA	1	-	1	3	1	2	8	-	8
ROBD	7	3	4	7	3	4	15	5	10
CLT	3	1	2	3	2	1	10	3	7
Others	2	1	1	2	-	2	1	-	1

PVH: Portal venous hypertension; HCC: Hepatocellular carcinomar; CLA: Cholangiocarcinoma; ROBD: Reoperation of bile duct; CLT: Cholelithiasis.

Table 2 Changes of nutritional status

Parameters	Control (n = 30)			TPN (n = 40)			EN (n = 65)
	1st BO*	5th PO**	10th PO	1st BO	5th PO	10th PO	1st BO	5th PO	10th PO
TRF (g/L)	1.1 ± 0.6	0.9 ± 0.3	0.8 ± 0.6	1.2 ± 0.4	1.0 ± 0.6	1.2 ± 0.3	1.3 ± 0.6	1.2 ± 0.5	1.2 ± 0.6
PAB (mg/L)	657 ± 232	591 ± 220	595 ± 213	690 ± 214	669 ± 228	667 ± 239	681 ± 228	719 ± 177	690 ± 221
TP (g/L)	63.6 ± 12.9	46.3 ± 9.7	48.1 ± 9.7	66.6 ± 12.2	48.3 ± 10.1	50.4 ± 9.6	70.1 ± 7.9	55.7 ± 7.8	63.5 ± 8.9
ALB (g/L)	30.8 ± 4.9	29.2 ± 5.9	29.1 ± 4.8	31.4 ± 4.9	30.8 ± 7.1	31.8 ± 5.0	36.5 ± 6.1	30.7 ± 4.0	32.9 ± 3.9
ANE	32.4 ± 10.8 mg·kg-1·7 d-1			105.3 ± 9.4 mg·kg-1·7 d-1			185.3 ± 8.4 mg·kg-1·7 d-1
W (kg)		-3.3 ± 1.7			-2.4 ± 1.1			-2.1 ± 0.9
COUA	23.5 ± 1.2	-	22.2 ± 1.3	23.6 ± 1.1	-	23.2 ± 1.3	24.4 ± 2.6	-	23.7 ± 2.2

BO: Before operation; PO: After operation; ANE: Accumulated nitrogen banlance; W: Weight change; COUA: Circumference of upper arm.

Table 3 Changes of liver and kidney function, electrolytes

Parameters	Control (n = 20)			TPN (n = 26)			EN (n = 30)
	1st BO	5th PO	10th PO	1st BO	5th PO	10th PO	1st BO	5th PO	10th PO
TB (µmol/L)*	92.3 ± 37.8	71.7 ± 34.5	41.8 ± 35.8	86.3 ± 46.8	68.7 ± 33.8	45.7 ± 33.2	119.8 ± 73.0	96.3 ± 54.4	64.3 ± 47.3
DB (µmol/L)*	53.3 ± 28.6	39.2 ± 23.3	16.5 ± 11.7	50.4 ± 33.7	38.4 ± 22.6	17.7 ± 12.3	60.8 ± 50.2	42.8 ± 32.7	31.9 ± 29.2
TP (g/L)*	63.6 ± 12.9	46.3 ± 9.7	48.1 ± 9.7	66.6 ± 12.2	48.3 ± 10.1	50.4 ± 9.6	70.1 ± 7.9	55.7 ± 7.8	63.5 ± 8.9
ALB (g/L)	30.8 ± 4.9	29.2 ± 5.9	29.1 ± 4.8	31.4 ± 4.9	30.8 ± 7.1	31.8 ± 5.0	36.5 ± 6.1	30.7 ± 4.0	32.9 ± 3.9
AST (U/L)#	71.7 ± 28.9	91.3 ± 33.5	78.7 ± 28.1	73.4 ± 30.6	89.9 ± 35.7	67.7 ± 39.1	94.8 ± 47.8	104.4 ± 80.7	69.6 ± 23.8
ALT (U/L)#	54.7 ± 31.1	101.4 ± 44.9	85.3 ± 33.7	58.7 ± 32.3	99.3 ± 56.2	78.7 ± 35.5	109.1 ± 82.7	148.4 ± 180	67.1 ± 50.1
Cr (µmol/L)	72.9 ± 28.8	82.1 ± 23.3	69.5 ± 37.9	73.9 ± 35.3	80.1 ± 22.9	67.5 ± 33.7	77.4 ± 16.5	80.6 ± 24.7	77.1 ± 19.6
BUN (mmol/L)	6.9 ± 3.3	8.4 ± 3.5	5.9 ± 3.4	7.1 ± 4.1	8.2 ± 3.7	5.6 ± 3.2	5.5 ± 1.8	6.9 ± 4.9	6.0 ± 3.2
K (mmol/L)	3.9 ± 0.5	5.3 ± 1.1	3.8 ± 0.7	3.8 ± 0.6	4.4 ± 0.9	4.3 ± 1.1	4.1 ± 0.5	4.3 ± 0.8	4.4 ± 0.2
Na (mmol/L)	136.5 ± 14.7	139.3 ± 18.3	145.8 ± 15.4	132.7 ± 15.9	140.3 ± 13.7	138.8 ± 7.3	138.3 ± 7.1	135.3 ± 5.7	137.0 ± 7.4
Ca (mmol/L)	2.35 ± 0.39	1.99 ± 0.18	2.17 ± 0.31	2.32 ± 0.43	2.67 ± 0.27	2.27 ± 0.34	2.21 ± 0.22	2.07 ± 0.14	2.24 ± 0.17

*among all 3 groups, between day 1 preopratively and day 10 postoperatively, P < 0.01; # at day 10 postoperatively, the levels were lower in EN and TPN group than in CON group, P < 0.05.

Table 4 Changes of L/M ratio

	1st BO	5th PO	10th PO
CON (n = 30)	0.028 ± 0.004	0.037 ± 0.017	0.031 ± 0.010
TPN (n = 40)	0.027 ± 0.003	0.038 ± 0.009	0.030 ± 0.006
EN (n = 65)	0.026 ± 0.004	0.030 ± 0.004	0.027 ± 0.005