Early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization

BACKGROUND: The abnormal metabolism caused by cir- rhosis always results in a complex problem about nutritional support, which will be more intricate while patients with portal hypertension are treated with pericardial devasculari- zation. Comparing the effects of early enteral and parente- ral nutritional support in patients with cirrhotic portal hy- pertension after pericardial devascularization, we try to rea lize the advantages and disadvantages of the two nutritional therapies and to guide our clinical practice. METHODS: After pericardial devascularization,40 patients with cirrhotic portal hypertension were divided randomly into 2 groups; enteral and parenteral nutritional support, respectively. The general nutritional condition, capability of producing protein, liver function, blood velocity of the portal vein, gut function, bowel bacterial translocation, mortality, complication rate, stay in ICU, duration of hos- pitalization and costs of treatment were determined in all the patients and compared between the 2 groups. RESULTS; Both enteral and parenteral nutritional supports could improve the general nutrition condition of the pa- tients; but patients receiving enteral nutritional support had fewer complications. Enteral nutrition was more ef- fective than parenteral nutrition in increasing the blood ve- locity of the portal vein, stimulating gut motion, preven- ting bowel bacterial translocation, shortening the stay in ICU and the duration of hospitalization, and saving costs of treatment. CONCLUSION: After pericardial devascularization, pa- tients with cirrhotic portal hypertension should be treated with enteral nutritional support as early as possible.