Document Detail


Hyperalimentation of jaundiced patients on percutaneous transhepatic biliary drainage.
MedLine Citation:
PMID:  3092894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although percutaneous transhepatic biliary drainage (PTBD) restores hepatic and renal function in patients with obstructive jaundice, it is not certain whether it reduces the rate of complications and death after biliopancreatic surgery. We studied the possibility that the operative risks of jaundiced patients are related to malnutrition and the usefulness of hyperalimentation with PTBD to reduce the incidence of complications. Sixty-four patients with obstructive jaundice and serum bilirubin greater than 200 mumol/l were randomized into two treatment groups (n = 32) with PTBD or PTBD + hyperalimentation. Four patients were withdrawn from the latter group, two for metastatic cancer and two for complications of PTBD. Before starting hyperalimentation, the incidence of malnutrition was assessed by biochemical, immunological and anthropometric tests: malnutrition was found in 70 per cent of the patients. All the patients had good recovery of hepatic function but patients treated with PTBD alone still had high mortality (12.5 per cent) and morbidity (46.8 per cent) after biliopancreatic surgery. When hyperalimentation was provided to patients on PTBD for a period of 20 days before the operation, the incidence of complications fell to 17.8 per cent and mortality to 3.5 per cent. These results suggest that the combined use of PTBD and hyperalimentation, improving both hepatic function tests and the nutritional status of jaundiced patients, can reduce the rate of complications after biliary and pancreatic surgery.
Authors:
D Foschi; G Cavagna; F Callioni; E Morandi; V Rovati
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The British journal of surgery     Volume:  73     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1986 Sep 
Date Detail:
Created Date:  1986-10-30     Completed Date:  1986-10-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  716-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Bile / microbiology
Cholestasis / microbiology,  physiopathology,  surgery*
Clinical Trials as Topic
Drainage
Enteral Nutrition
Female
Humans
Liver / physiopathology
Liver Function Tests
Male
Nutrition Disorders / etiology,  therapy*
Parenteral Nutrition, Total
Postoperative Complications / prevention & control*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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