Hepatic resections are commonly associated with high morbidity and mortality. Nutrition plays an important role in reducing postoperative complications besides improvement in intensive care and perioperative management.
<bold>The aim of the study </bold>was to evaluate the role of glutamine as an immunonutrient in patients undergoing hepatic resection.
<bold>Material and methods. </bold>The study included 22 patients who underwent hepatectomy. Patients were randomized into two equal groups wherein group A patients received perioperative glutamine whereas group B patients served as controls. Primary outcome measures were level of serum albumin, C‑reactive protein (CRP), liver function tests and absolute neutrophil counts in the postoperative period while secondary outcome included post operative complications.
<bold>Results. </bold>Glutamine decreased the CRP response in liver resection in a statistically significant manner (p=0.028) on the fifth post operative day. This may signify that glutamine decreases the post operative inflammatory response associated with liver resection. Glutamine did not have any significant effect on liver function tests. Postoperative morbidity was less in patients who received glutamine.
<bold>Conclusion. </bold>Glutamine successfully blunted the CRP response in patients who received glutamine postoperatively. Decrease in morbidity following glutamine administration is an attractive area of prospective research and requires further consideration involving larger patient groups.
1. Poon RT, Fan ST, Lo CM et al.: Improving perioperative outcome expands the role of hepatectomy in management of benign and malignant hepatobiliary diseases: analysis of 1222 consecutive patients from a prospective database. Ann Surg 2004; 240: 698-708.
2. Fan ST, Lo CM, Lai ECS et al.: Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma N Engl J Med 1994; 331: 1547-52.
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