Application of enteral nutrition support in treatment of malignant obstructive jaundice_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yang , JIN Junhua ,  ZHAO Haiping

Department of Hepatobiliary Pancreatic Splenic Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, P. R. China;

Corresponding author：

ZHAO Haiping, Email: zhaohaiping007@aliyun.com

Keywords：

malignant obstructive jaundice; enteral nutrition; biliary tract neoplasm

DOI：

10.7507/1007-9424.202110097

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To understand the related application and future development trend of enteral nutrition (EN) support in the treatment of patients with malignant obstructive jaundice (MOJ), and provide a reference for clinical decision-making. Method The relevant literatures on EN support in the treatment of MOJ at home and abroad in recent years were reviewed. Results In the treatment of patients with MOJ, EN support treatment could maintain the integrity of intestinal mucosal barrier function, reduce intestinal permeability, and reduce bacterial ectopic. At the same time, it could effectively improve the immune function of patients, promote the recovery of liver function, reduce the stress response of patients, reduce the incidence of complications, accelerate the postoperative recovery of patients and shorten the hospitalization time of patients. Conclusion EN support is an important measure in treatment of MOJ, which can obviously promote recovery of patients.

Citation： LIU Yang, JIN Junhua, ZHAO Haiping. Application of enteral nutrition support in treatment of malignant obstructive jaundice. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(7): 976-980. doi: 10.7507/1007-9424.202110097 Copy

1.	Rizzo A, Ricci AD, Frega G, et al. How to choose between percutaneous transhepatic and endoscopic biliary drainage in malignant obstructive jaundice: an updated systematic review and meta-analysis. In Vivo, 2020, 34(4): 1701-1714.
2.	Rizzo A, Frega G, Ricci AD, et al. Anti-EGFR monoclonal antibodies in advanced biliary tract cancer: a systematic review and meta-analysis. In Vivo, 2020, 34(2): 479-488.
3.	刘颖斌, 王许安. 胆道恶性肿瘤外科治疗的问题和对策. 中华消化外科杂志, 2019, 18(2): 117-122.
4.	Marshall KM, Loeliger J, Nolte L, et al. Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points. Clin Nutr, 2019, 38(2): 644-651.
5.	夏羽菲, 张华楠, 秦鸿雁, 等. 营养支持治疗方案的研究进展. 医学争鸣, 网络首发时间: 2021-09-28 18: 43: 56. http://kns.cnki.net/kcms/detail/61.1481.R.20210928.0358.006.html.
6.	Wilmore DW, Dudrick SJ. Growth and development of an infant receiving all nutrients exclusively by vein. JAMA, 1968, 203(10): 860-864.
7.	Ma BQ, Chen SY, Jiang ZB, et al. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol, 2020, 26(46): 7405-7415.
8.	陈莹, 张雅敏. 围手术期肠内、外营养治疗在肝切除术后患者快速康复中的作用. 天津医科大学学报, 2021, 27(4): 384-387.
9.	高鹏, 王楠, 吴迪, 等. 肠内营养对胃癌术后患者短期内营养状况和生活质量的影响. 中华内分泌外科杂志, 2020, 14(6): 445-449.
10.	石汉平, 杨柳青. 恶性肿瘤营养不良的五大特征. 中国中西医结合学会营养学专业委员会. 第十届全国中西医结合营养学术会议论文资料汇编. 中国中西医结合学会营养学专业委员会: 中国中西医结合学会, 2019: 1.
11.	姚柏宇, 田忠. 胆汁酸及其相关核受体对肠黏膜屏障的影响. 中华肝胆外科杂志, 2020, 26(2): 158-160.
12.	段希斌, 李学民, 王忠振, 等. 多种油脂肪乳对肝门部胆管癌术后患者炎症反应及凝血功能的影响. 肿瘤基础与临床, 2021, 34(4): 303-307.
13.	Assimakopoulos SF, Akinosoglou K, de Lastic AL, et al. The prognostic value of endotoxemia and intestinal barrier biomarker ZO-1 in bacteremic sepsis. Am J Med Sci, 2020, 359(2): 100-107.
14.	Murakami Y, Tanabe S, Suzuki T. High-fat diet-induced intestinal hyperpermeability is associated with increased bile acids in the large intestine of mice. J Food Sci, 2016, 81(1): H216-H222. doi: 10.1111/1750-3841.13166.
15.	Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
16.	Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
17.	Nilsson A, Wilhelms DB, Mirrasekhian E, et al. Inflammation-induced anorexia and fever are elicited by distinct prostaglandin dependent mechanisms, whereas conditioned taste aversion is prostaglandin independent. Brain Behav Immun, 2017, 61: 236-243.
18.	Patel HJ, Patel BM. TNF-α and cancer cachexia: molecular insights and clinical implications. Life Sci, 2017, 170: 56-63.
19.	Cole CL, Kleckner IR, Jatoi A, et al. The role of systemic inflammation in cancer-associated muscle wasting and rationale for exercise as a therapeutic intervention. JCSM Clin Rep, 2018, 3(2): e00065.
20.	Zhang Z, Zhang X, Hu Z, et al. Lack of K-dependent oxidative stress in cotton roots following coronatine-induced ROS accumulation. PLoS One, 2015, 10(5): e0126476. doi: 10.1371/journal.pone.0126476.
21.	Zhao Y, Sun Y, Ding Y, et al. GL-V9, a new synthetic flavonoid derivative, ameliorates DSS-induced colitis against oxidative stress by up-regulating Trx-1 expression via activation of AMPK/FOXO3a pathway. Oncotarget, 2015, 6(28): 26291-26307.
22.	Tan SJ, Yu C, Yu Z, et al. High-fat enteral nutrition reduces intestinal mucosal barrier damage after peritoneal air exposure. J Surg Res, 2016, 202(1): 77-86.
23.	黄忠义, 陈飞, 张贯启, 等. 黄芪多糖对梗阻性黄疸大鼠肠损害的治疗作用及其机制探讨. 山东医药, 2020, 60(12): 32-36.
24.	Lin ZL, Tan SJ, Cheng MH, et al. Lipid-rich enteral nutrition controls intestinal inflammation, improves intestinal motility and mucosal barrier damage in a rat model of intestinal ischemia/reperfusion injury. J Surg Res, 2017, 213: 75-83.
25.	蹇艾利, 郭乐, 申元英, 等. 脓毒血症的研究机制及免疫炎症因子吸附装置. 中国免疫学杂志, 1-14[2021-11-02]. http://kns.cnki.net/kcms/detail/22.1126.r.20210630.1628.040.html.
26.	Badger SA, Jones C, McCaigue M, et al. Cytokine response to portal endotoxaemia and neutrophil stimulation in obstructive jaundice. Eur J Gastroenterol Hepatol, 2012, 24(1): 25-32.
27.	虞向阳, 杨光华, 陈俊卯, 等. 肠外联合肠内营养对恶性梗阻性黄疸PTCD术后肝功能指标的影响. 中国医药导报, 2017, 14(29): 107-110.
28.	李杨宇婧, 柏海涛. 肠内和肠外营养对脓毒症患者肝损伤的保护作用. 中国现代普通外科进展, 2019, 22(9): 717-719.
29.	胡艳杰, 李卡, 杨家印, 等. 肝移植患者术后益生菌强化的早期肠内营养使用的最佳证据总结. 中国普外基础与临床杂志, 2020, 27(1): 63-68.
30.	李保成, 赵刚. 术后早期肠内与肠外营养对食管癌患者应激反应、营养状况及恢复的影响. 临床医学研究与实践, 2020, 5(1): 74-75.
31.	刘锐, 陈伟伟, 黄坤, 等. MNA-SF和NRS 2002评估老年恶性梗阻性黄疸病人营养状况及其影响因素的应用研究. 肠外与肠内营养, 2019, 26(2): 14-18.
32.	韩山山, 赵君会, 叶军, 等. NRS-2002与MNA-SF营养评估对恶性梗阻性黄疸患者术后生存期的预测价值. 临床肝胆病杂志, 2019, 35(8): 1755-1759.
33.	杨敏, 邓辉胜. 老年患者肠内营养管饲途径的选择. 现代医药卫生, 2016, 32(1): 63-65.
34.	柳长明, 崔国利, 赵广阳, 等. 空肠插管造口术在消化外科肠内营养中的应用. 上海医药, 2020, 41(23): 49-51.
35.	Wallstabe I, Tiedemann A, Schiefke I, et al. Endoscopic and surgical procedures for enteral nutrition. Chirurg, 2013, 84(7): 559-565.
36.	张娟娟, 汪志明. 经皮内镜下胃/空肠造瘘术的临床应用进展. 医学研究生学报, 2021, 34(6): 668-672.
37.	陈大伟, 费哲为, 王小军, 等. 免气腹单孔腹腔镜辅助空肠造口术. 中国微创外科杂志, 2013, 13(4): 347-348.
38.	于杰, 张兴元. 早期生态免疫肠内营养对于梗阻性黄疸患者术后免疫与肠黏膜屏障的影响分析. 健康大视野, 2020, (6): 248.
39.	杨方亮, 江勇, 姚捷, 等. 富含中链脂肪酸和蛋白的肠内营养对恶性梗阻性黄疸手术病人肠屏障功能的影响. 肠外与肠内营养, 2017, 24(6): 351-354.

1. Rizzo A, Ricci AD, Frega G, et al. How to choose between percutaneous transhepatic and endoscopic biliary drainage in malignant obstructive jaundice: an updated systematic review and meta-analysis. In Vivo, 2020, 34(4): 1701-1714.
2. Rizzo A, Frega G, Ricci AD, et al. Anti-EGFR monoclonal antibodies in advanced biliary tract cancer: a systematic review and meta-analysis. In Vivo, 2020, 34(2): 479-488.
3. 刘颖斌, 王许安. 胆道恶性肿瘤外科治疗的问题和对策. 中华消化外科杂志, 2019, 18(2): 117-122.
4. Marshall KM, Loeliger J, Nolte L, et al. Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points. Clin Nutr, 2019, 38(2): 644-651.
5. 夏羽菲, 张华楠, 秦鸿雁, 等. 营养支持治疗方案的研究进展. 医学争鸣, 网络首发时间: 2021-09-28 18: 43: 56. http://kns.cnki.net/kcms/detail/61.1481.R.20210928.0358.006.html.
6. Wilmore DW, Dudrick SJ. Growth and development of an infant receiving all nutrients exclusively by vein. JAMA, 1968, 203(10): 860-864.
7. Ma BQ, Chen SY, Jiang ZB, et al. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol, 2020, 26(46): 7405-7415.
8. 陈莹, 张雅敏. 围手术期肠内、外营养治疗在肝切除术后患者快速康复中的作用. 天津医科大学学报, 2021, 27(4): 384-387.
9. 高鹏, 王楠, 吴迪, 等. 肠内营养对胃癌术后患者短期内营养状况和生活质量的影响. 中华内分泌外科杂志, 2020, 14(6): 445-449.
10. 石汉平, 杨柳青. 恶性肿瘤营养不良的五大特征. 中国中西医结合学会营养学专业委员会. 第十届全国中西医结合营养学术会议论文资料汇编. 中国中西医结合学会营养学专业委员会: 中国中西医结合学会, 2019: 1.
11. 姚柏宇, 田忠. 胆汁酸及其相关核受体对肠黏膜屏障的影响. 中华肝胆外科杂志, 2020, 26(2): 158-160.
12. 段希斌, 李学民, 王忠振, 等. 多种油脂肪乳对肝门部胆管癌术后患者炎症反应及凝血功能的影响. 肿瘤基础与临床, 2021, 34(4): 303-307.
13. Assimakopoulos SF, Akinosoglou K, de Lastic AL, et al. The prognostic value of endotoxemia and intestinal barrier biomarker ZO-1 in bacteremic sepsis. Am J Med Sci, 2020, 359(2): 100-107.
14. Murakami Y, Tanabe S, Suzuki T. High-fat diet-induced intestinal hyperpermeability is associated with increased bile acids in the large intestine of mice. J Food Sci, 2016, 81(1): H216-H222. doi: 10.1111/1750-3841.13166.
15. Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
16. Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
17. Nilsson A, Wilhelms DB, Mirrasekhian E, et al. Inflammation-induced anorexia and fever are elicited by distinct prostaglandin dependent mechanisms, whereas conditioned taste aversion is prostaglandin independent. Brain Behav Immun, 2017, 61: 236-243.
18. Patel HJ, Patel BM. TNF-α and cancer cachexia: molecular insights and clinical implications. Life Sci, 2017, 170: 56-63.
19. Cole CL, Kleckner IR, Jatoi A, et al. The role of systemic inflammation in cancer-associated muscle wasting and rationale for exercise as a therapeutic intervention. JCSM Clin Rep, 2018, 3(2): e00065.
20. Zhang Z, Zhang X, Hu Z, et al. Lack of K-dependent oxidative stress in cotton roots following coronatine-induced ROS accumulation. PLoS One, 2015, 10(5): e0126476. doi: 10.1371/journal.pone.0126476.
21. Zhao Y, Sun Y, Ding Y, et al. GL-V9, a new synthetic flavonoid derivative, ameliorates DSS-induced colitis against oxidative stress by up-regulating Trx-1 expression via activation of AMPK/FOXO3a pathway. Oncotarget, 2015, 6(28): 26291-26307.
22. Tan SJ, Yu C, Yu Z, et al. High-fat enteral nutrition reduces intestinal mucosal barrier damage after peritoneal air exposure. J Surg Res, 2016, 202(1): 77-86.
23. 黄忠义, 陈飞, 张贯启, 等. 黄芪多糖对梗阻性黄疸大鼠肠损害的治疗作用及其机制探讨. 山东医药, 2020, 60(12): 32-36.
24. Lin ZL, Tan SJ, Cheng MH, et al. Lipid-rich enteral nutrition controls intestinal inflammation, improves intestinal motility and mucosal barrier damage in a rat model of intestinal ischemia/reperfusion injury. J Surg Res, 2017, 213: 75-83.
25. 蹇艾利, 郭乐, 申元英, 等. 脓毒血症的研究机制及免疫炎症因子吸附装置. 中国免疫学杂志, 1-14[2021-11-02]. http://kns.cnki.net/kcms/detail/22.1126.r.20210630.1628.040.html.
26. Badger SA, Jones C, McCaigue M, et al. Cytokine response to portal endotoxaemia and neutrophil stimulation in obstructive jaundice. Eur J Gastroenterol Hepatol, 2012, 24(1): 25-32.
27. 虞向阳, 杨光华, 陈俊卯, 等. 肠外联合肠内营养对恶性梗阻性黄疸PTCD术后肝功能指标的影响. 中国医药导报, 2017, 14(29): 107-110.
28. 李杨宇婧, 柏海涛. 肠内和肠外营养对脓毒症患者肝损伤的保护作用. 中国现代普通外科进展, 2019, 22(9): 717-719.
29. 胡艳杰, 李卡, 杨家印, 等. 肝移植患者术后益生菌强化的早期肠内营养使用的最佳证据总结. 中国普外基础与临床杂志, 2020, 27(1): 63-68.
30. 李保成, 赵刚. 术后早期肠内与肠外营养对食管癌患者应激反应、营养状况及恢复的影响. 临床医学研究与实践, 2020, 5(1): 74-75.
31. 刘锐, 陈伟伟, 黄坤, 等. MNA-SF和NRS 2002评估老年恶性梗阻性黄疸病人营养状况及其影响因素的应用研究. 肠外与肠内营养, 2019, 26(2): 14-18.
32. 韩山山, 赵君会, 叶军, 等. NRS-2002与MNA-SF营养评估对恶性梗阻性黄疸患者术后生存期的预测价值. 临床肝胆病杂志, 2019, 35(8): 1755-1759.
33. 杨敏, 邓辉胜. 老年患者肠内营养管饲途径的选择. 现代医药卫生, 2016, 32(1): 63-65.
34. 柳长明, 崔国利, 赵广阳, 等. 空肠插管造口术在消化外科肠内营养中的应用. 上海医药, 2020, 41(23): 49-51.
35. Wallstabe I, Tiedemann A, Schiefke I, et al. Endoscopic and surgical procedures for enteral nutrition. Chirurg, 2013, 84(7): 559-565.
36. 张娟娟, 汪志明. 经皮内镜下胃/空肠造瘘术的临床应用进展. 医学研究生学报, 2021, 34(6): 668-672.
37. 陈大伟, 费哲为, 王小军, 等. 免气腹单孔腹腔镜辅助空肠造口术. 中国微创外科杂志, 2013, 13(4): 347-348.
38. 于杰, 张兴元. 早期生态免疫肠内营养对于梗阻性黄疸患者术后免疫与肠黏膜屏障的影响分析. 健康大视野, 2020, (6): 248.
39. 杨方亮, 江勇, 姚捷, 等. 富含中链脂肪酸和蛋白的肠内营养对恶性梗阻性黄疸手术病人肠屏障功能的影响. 肠外与肠内营养, 2017, 24(6): 351-354.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of enteral nutrition support in treatment of malignant obstructive jaundice

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