Evaluation of Postoperative Intravenous Hyperalimentation for Patients with Hepatocellular Carcinoma Treated by Minimal Surgery

Aim: To identify which patients undergoing hepatic surgery for hepatocellular carcinoma (HCC) require postoperative intravenous hyperalimentation (IVH). Materials & Methods: Eighty patients with HCC who underwent limited resection (segmentectomy according to Couinaud's classification or less) or laparotomic microwave coagulation between 2001 and 2003 were classified based on whether they received postoperative IVH (IVH group; 62 cases: 48 men and 14 women; 7 treated by laparotomic microwave coagulation and 55 treated by partial resection)(non-IVH group; 18 cases; 12 men and 6 women; 6 treated by laparotomic microwave coagulation, and 12 treated by partial resection). Gender, age, body weight, liver function, weight of the surgical specimen, intravenously infused calories per day, postoperative complications, day of oral ingestion restarted, and day of discharge were compared. Results: In the non-IVH group, mean age was 64.1 years old, weight, 57.3 kg; weight of surgical specimen, 17. 1 g; 15 patients were Child-Pugh's class A and 3 class B; intravenously infused calories, 469. 3 Kcal; days until oral ingestion restarted, 2.3 days; and length of stay, 19. 9 days. One patient in the non-IVH group developed a minor bile leak, but there was no hospital death. The mean number of daily intravenously infused calories before oral ingestion in the non-IVH group was lower (p