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.	劉穎斌, 王許安. 膽道惡性腫瘤外科治療的問題和對策. 中華消化外科雜志, 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, 張華楠, 秦鴻雁, 等. 營養支持治療方案的研究進展. 醫學爭鳴, 網絡首發時間: 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.	陳瑩, 張雅敏. 圍手術期腸內、外營養治療在肝切除術后患者快速康復中的作用. 天津醫科大學學報, 2021, 27(4): 384-387.
9.	高鵬, 王楠, 吳迪, 等. 腸內營養對胃癌術后患者短期內營養狀況和生活質量的影響. 中華內分泌外科雜志, 2020, 14(6): 445-449.
10.	石漢平, 楊柳青. 惡性腫瘤營養不良的五大特征. 中國中西醫結合學會營養學專業委員會. 第十屆全國中西醫結合營養學術會議論文資料匯編. 中國中西醫結合學會營養學專業委員會: 中國中西醫結合學會, 2019: 1.
11.	姚柏宇, 田忠. 膽汁酸及其相關核受體對腸黏膜屏障的影響. 中華肝膽外科雜志, 2020, 26(2): 158-160.
12.	段希斌, 李學民, 王忠振, 等. 多種油脂肪乳對肝門部膽管癌術后患者炎癥反應及凝血功能的影響. 腫瘤基礎與臨床, 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.	黃忠義, 陳飛, 張貫啟, 等. 黃芪多糖對梗阻性黃疸大鼠腸損害的治療作用及其機制探討. 山東醫藥, 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, 郭樂, 申元英, 等. 膿毒血癥的研究機制及免疫炎癥因子吸附裝置. 中國免疫學雜志, 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.	虞向陽, 楊光華, 陳俊卯, 等. 腸外聯合腸內營養對惡性梗阻性黃疸PTCD術后肝功能指標的影響. 中國醫藥導報, 2017, 14(29): 107-110.
28.	李楊宇婧, 柏海濤. 腸內和腸外營養對膿毒癥患者肝損傷的保護作用. 中國現代普通外科進展, 2019, 22(9): 717-719.
29.	胡艷杰, 李卡, 楊家印, 等. 肝移植患者術后益生菌強化的早期腸內營養使用的最佳證據總結. 中國普外基礎與臨床雜志, 2020, 27(1): 63-68.
30.	李保成, 趙剛. 術后早期腸內與腸外營養對食管癌患者應激反應、營養狀況及恢復的影響. 臨床醫學研究與實踐, 2020, 5(1): 74-75.
31.	劉銳, 陳偉偉, 黃坤, 等. MNA-SF和NRS 2002評估老年惡性梗阻性黃疸病人營養狀況及其影響因素的應用研究. 腸外與腸內營養, 2019, 26(2): 14-18.
32.	韓山山, 趙君會, 葉軍, 等. NRS-2002與MNA-SF營養評估對惡性梗阻性黃疸患者術后生存期的預測價值. 臨床肝膽病雜志, 2019, 35(8): 1755-1759.
33.	楊敏, 鄧輝勝. 老年患者腸內營養管飼途徑的選擇. 現代醫藥衛生, 2016, 32(1): 63-65.
34.	柳長明, 崔國利, 趙廣陽, 等. 空腸插管造口術在消化外科腸內營養中的應用. 上海醫藥, 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.	張娟娟, 汪志明. 經皮內鏡下胃/空腸造瘺術的臨床應用進展. 醫學研究生學報, 2021, 34(6): 668-672.
37.	陳大偉, 費哲為, 王小軍, 等. 免氣腹單孔腹腔鏡輔助空腸造口術. 中國微創外科雜志, 2013, 13(4): 347-348.
38.	于杰, 張興元. 早期生態免疫腸內營養對于梗阻性黃疸患者術后免疫與腸黏膜屏障的影響分析. 健康大視野, 2020, (6): 248.
39.	楊方亮, 江勇, 姚捷, 等. 富含中鏈脂肪酸和蛋白的腸內營養對惡性梗阻性黃疸手術病人腸屏障功能的影響. 腸外與腸內營養, 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. 劉穎斌, 王許安. 膽道惡性腫瘤外科治療的問題和對策. 中華消化外科雜志, 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, 張華楠, 秦鴻雁, 等. 營養支持治療方案的研究進展. 醫學爭鳴, 網絡首發時間: 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. 陳瑩, 張雅敏. 圍手術期腸內、外營養治療在肝切除術后患者快速康復中的作用. 天津醫科大學學報, 2021, 27(4): 384-387.
9. 高鵬, 王楠, 吳迪, 等. 腸內營養對胃癌術后患者短期內營養狀況和生活質量的影響. 中華內分泌外科雜志, 2020, 14(6): 445-449.
10. 石漢平, 楊柳青. 惡性腫瘤營養不良的五大特征. 中國中西醫結合學會營養學專業委員會. 第十屆全國中西醫結合營養學術會議論文資料匯編. 中國中西醫結合學會營養學專業委員會: 中國中西醫結合學會, 2019: 1.
11. 姚柏宇, 田忠. 膽汁酸及其相關核受體對腸黏膜屏障的影響. 中華肝膽外科雜志, 2020, 26(2): 158-160.
12. 段希斌, 李學民, 王忠振, 等. 多種油脂肪乳對肝門部膽管癌術后患者炎癥反應及凝血功能的影響. 腫瘤基礎與臨床, 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. 黃忠義, 陳飛, 張貫啟, 等. 黃芪多糖對梗阻性黃疸大鼠腸損害的治療作用及其機制探討. 山東醫藥, 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, 郭樂, 申元英, 等. 膿毒血癥的研究機制及免疫炎癥因子吸附裝置. 中國免疫學雜志, 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. 虞向陽, 楊光華, 陳俊卯, 等. 腸外聯合腸內營養對惡性梗阻性黃疸PTCD術后肝功能指標的影響. 中國醫藥導報, 2017, 14(29): 107-110.
28. 李楊宇婧, 柏海濤. 腸內和腸外營養對膿毒癥患者肝損傷的保護作用. 中國現代普通外科進展, 2019, 22(9): 717-719.
29. 胡艷杰, 李卡, 楊家印, 等. 肝移植患者術后益生菌強化的早期腸內營養使用的最佳證據總結. 中國普外基礎與臨床雜志, 2020, 27(1): 63-68.
30. 李保成, 趙剛. 術后早期腸內與腸外營養對食管癌患者應激反應、營養狀況及恢復的影響. 臨床醫學研究與實踐, 2020, 5(1): 74-75.
31. 劉銳, 陳偉偉, 黃坤, 等. MNA-SF和NRS 2002評估老年惡性梗阻性黃疸病人營養狀況及其影響因素的應用研究. 腸外與腸內營養, 2019, 26(2): 14-18.
32. 韓山山, 趙君會, 葉軍, 等. NRS-2002與MNA-SF營養評估對惡性梗阻性黃疸患者術后生存期的預測價值. 臨床肝膽病雜志, 2019, 35(8): 1755-1759.
33. 楊敏, 鄧輝勝. 老年患者腸內營養管飼途徑的選擇. 現代醫藥衛生, 2016, 32(1): 63-65.
34. 柳長明, 崔國利, 趙廣陽, 等. 空腸插管造口術在消化外科腸內營養中的應用. 上海醫藥, 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. 張娟娟, 汪志明. 經皮內鏡下胃/空腸造瘺術的臨床應用進展. 醫學研究生學報, 2021, 34(6): 668-672.
37. 陳大偉, 費哲為, 王小軍, 等. 免氣腹單孔腹腔鏡輔助空腸造口術. 中國微創外科雜志, 2013, 13(4): 347-348.
38. 于杰, 張興元. 早期生態免疫腸內營養對于梗阻性黃疸患者術后免疫與腸黏膜屏障的影響分析. 健康大視野, 2020, (6): 248.
39. 楊方亮, 江勇, 姚捷, 等. 富含中鏈脂肪酸和蛋白的腸內營養對惡性梗阻性黃疸手術病人腸屏障功能的影響. 腸外與腸內營養, 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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