Higuchi Ryota, Yamamoto Masakazu
Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2010 Nov;111(6):363-7.
The field of hepatobiliary-pancreatic surgery involves performing hepatectomy, pancreatectomy, and hepatopancreatoduodenectomy, which are all very invasive procedures. Since bile and pancreatic juice are associated with the etiology of disease, appropriate management is necessary for patients with chronic hepatitis, liver cirrhosis, obstructive jaundice, deteriorating internal and external secretory function of the pancreas and digestive organs, and absorption disorders. Because malnutrition increases the risk of postoperative morbidity and mortality, it is important for patients to maintain good nutritional status during the perioperative period to improve the postoperative outcome. Recently, the efficacy of branched-chain amino acid administration for liver cirrhosis, bile replacement for obstructive jaundice, early enteral nutrition, immunonutrition, and synbiotics has been reported and therefore these management approaches should be considered carefully in patients undergoing hepatobiliary-pancreatic surgery.
肝胆胰外科领域涉及实施肝切除术、胰腺切除术和肝胰十二指肠切除术，这些都是极具侵入性的手术。由于胆汁和胰液与疾病病因相关，对于患有慢性肝炎、肝硬化、梗阻性黄疸、胰腺及消化器官内外分泌功能恶化以及吸收障碍的患者，进行适当的管理很有必要。由于营养不良会增加术后发病和死亡风险，患者在围手术期保持良好的营养状态以改善术后结局非常重要。最近，已报道了支链氨基酸给药对肝硬化的疗效、梗阻性黄疸的胆汁替代、早期肠内营养、免疫营养和合生元的作用，因此在接受肝胆胰手术的患者中应仔细考虑这些管理方法。
