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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 9
Sep.  2021
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Article Contents

Expert opinion on nutritional treatment for patients with biliary tract tumors

DOI: 10.3969/j.issn.1001-5256.2021.09.011
Research funding:

National Key Research and Development Program (2017YFC1309203)

  • Received Date: 2020-07-29
  • Accepted Date: 2021-07-29
  • Published Date: 2021-09-20
  • Although biliary tract Chinese Society of Nutritional Oncology malignancy is not common in the world, its incidence is increasing year by year and its malignancy is high. The incidence of biliary tract malignancy in China is also increasing year by year. The prognosis of patients with cholangiocarcinoma is poor. Therefore, the palliative and supportive treatments of malignant tumors of the biliary tract system are particularly important, with the main purpose of improving the quality of life and extending the survival time as much as possible. The malignant tumor palliative biliary system and nutrition treatment is particularly important. Its main purpose is to improve the quality of life as much as possible, to prolong survival time. Early postoperative feeding in patients with hilar cholangiocarcinoma can effectively reduce the incidence of complications such as abdominal distention and urinary retention, and accelerate postoperative rehabilitation of patients. The principle of selection of nutritional treatment approaches for biliary tract malignant tumors is basically the same as that for other malignant tumors, but it also has its characteristics: 1. biliary tract surgery is mostly limited to the upper digestive tract, and the intestinal canal below the jejunum is less affected. 2. For patients with preoperative malnutrition, especially those with moderate or above obstructive jaundice, enteral nutrition through oral or nasojejunal catheterization or through T-tube jejunal catheterization is recommended. For patients with poor liver function reserve and extensive hepatectomy or severe obstructive jaundice, biliary stent drainage or percutaneous hepatocentesis biliary drainage should be actively performed for biliary decompression, so as to improve liver function as soon as possible and promote the metabolism and absorption of nutrients. 4.PTCD is a method widely used in clinical treatment of malignant biliary obstruction.

     

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  • [1]
    HUNDAL R, SHAFFER EA. Gallbladder cancer: Epidemiology and outcome[J]. Clin Epidemiol, 2014, 6: 99-109. DOI: 10.2147/CLEP.S37357.
    [2]
    GONG XL, QIN SK, LIU XF. Progress of medical treatment for biliary tract cancer[J]. Chin Clin Oncol, 2013, 18(5): 459-467. DOI: 10.3969/j.issn.1009-0460.2013.05.018.

    龚新雷, 秦叔逵, 刘秀峰. 胆系肿瘤的内科治疗进展[J]. 临床肿瘤学杂志, 2013, 18(5): 459-467. DOI: 10.3969/j.issn.1009-0460.2013.05.018.
    [3]
    LAZCANO-PONCE EC, MIQUEL JF, MUÑOZ N, et al. Epidemiology and molecular pathology of gallbladder cancer[J]. CA Cancer J Clin, 2001, 51(6): 349-364. DOI: 10.3322/canjclin.51.6.349.
    [4]
    TUO JY, ZHANG M, ZHENG RS, et al. Report of incidence and mortality of gallbladder cancer in China, 2014[J]. Chin J Oncol, 2018, 40(12): 894-899. DOI: 10.3760/cma.j.issn.0253-3766.2018.12.004.

    庹吉妤, 张敏, 郑荣寿, 等. 中国2014年胆囊癌发病与死亡情况分析[J]. 中华肿瘤杂志, 2018, 40(12): 894-899. DOI: 10.3760/cma.j.issn.0253-3766.2018.12.004.
    [5]
    LEVY AD, MURAKATA LA, ROHRMANN CA Jr. Gallbladder carcinoma: Radiologic-pathologic correlation[J]. Radiographics, 2001, 21(2): 295-314; questionnaire, 549-555. DOI: 10.1148/radiographics.21.2.g01mr16295.
    [6]
    RAI A, TEWARI M, MOHAPATRA SC, et al. Correlation of nutritional parameters of gallbladder cancer patients[J]. J Surg Oncol, 2006, 93(8): 705-708. DOI: 10.1002/jso.20539.
    [7]
    GUO J, ZHOU YB, ZHAI ZM, et al. Malnutrition evaluation and postoperative complications in patients with hilar cholangiocarcinoma[J]. Chin J Gen Pract, 2016, 14 (8): 1266-1268. DOI: 10.16766/j.cnki.issn.1674-4152.2016.08.007.

    郭剑, 周永斌, 翟泽民, 等. 肝门部胆管癌患者营养不良评估与术后并发症的相关研究[J]. 中华全科医学, 2016, 14 (8): 1266-1268. DOI: 10.16766/j.cnki.issn.1674-4152.2016.08.007.
    [8]
    MIYATA T, YAMASHITA YI, HIGASHI T, et al. The prognostic impact of controlling nutritional status (CONUT) in intrahepatic cholangiocarcinoma following curative hepatectomy: A retrospective single institution study[J]. World J Surg, 2018, 42(4): 1085-1091. DOI: 10.1007/s00268-017-4214-1.
    [9]
    SHIRAKAWA H, KINOSHITA T, GOTOHDA N, et al. Compliance with and effects of preoperative immunonutrition in patients undergoing pancreaticoduodenectomy[J]. J Hepatobiliary Pancreat Sci, 2012, 19(3): 249-58. DOI: 10.1007/s00534-011-0416-3.
    [10]
    MARIETTE C, de BOTTON ML, PIESSEN G. Surgery inesophageal and gastric cancer patients: What is the role for nutrition support in your daily practice?[J]. Ann Surg Oncol, 2012, 19(7): 2128-2134. DOI: 10.1245/s10434-012-2225-6.
    [11]
    LIU SH. Effect of perioperative nutritional risk screening and nutritional support on clinical outcome in patients undergoing hepatobiliary surgery[D]. Guangzhou: Southern Medical University, 2016.

    刘升辉. 肝胆手术病人围手术期营养风险筛查及营养支持对临床结局的影响[D]. 广州: 南方医科大学, 2016.
    [12]
    LILLEMOE HA, ALOIA TA. Enhanced recovery after surgery: Hepatobiliary[J]. Surg Clin North Am, 2018, 98(6): 1251-1264. DOI: 10.1016/j.suc.2018.07.011.
    [13]
    ARENDS J, BACHMANN P, BARACOS V, et al. ESPEN guidelines on nutrition in cancer patients[J]. Clin Nutr, 2017, 36(1): 11-48. DOI: 10.1016/j.clnu.2016.07.015.
    [14]
    MANSOUR JC, ALOIA TA, CRANE CH, et al. Hilar cholangiocarcinoma: Expert consensus statement[J]. HPB (Oxford), 2015, 17(8): 691-699. DOI: 10.1111/hpb.12450.
    [15]
    SUN XM, TANG XF, SUN LY. Therapeutic strategy to malignant biliary obstruction[J/CD]. Electronic J Metabol Nutr Cancer, 2017, 4 (1): 11-15. DOI: 10.16689/j.cnki.cn11-9349/r.2017.01.003.

    孙晓梅, 唐秀芬, 孙凌宇. 恶性胆道梗阻的治疗对策[J/CD]. 肿瘤代谢与营养电子杂志, 2017, 4 (1): 11-15. DOI: 10.16689/j.cnki.cn11-9349/r.2017.01.003.
    [16]
    ZHAO XH, TANG J, TENG CL, et al. The influence of bile reinfusion on postoperative complications and nutritional status in patients after pancreaticoduodenectomy[J]. J Guangxi Med Univ, 2017, 34 (5): 746-750. DOI: 10.16190/j.cnki.45-1211/r.2017.05.029.

    赵新华, 唐娟, 滕春兰, 等. 胆汁回输对胰十二指肠切除患者术后并发症及营养状态的影响[J]. 广西医科大学学报, 2017, 34 (5): 746-750. DOI: 10.16190/j.cnki.45-1211/r.2017.05.029.
    [17]
    HESLIN MJ, LATKANY L, LEUNG D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy[J]. Ann Surg, 1997, 226(4): 567-577; discussion 577-580. DOI: 10.1097/00000658-199710000-00016.
    [18]
    WAKAHARA T, SHIRAKI M, MURASE K, et al. Nutritional screening with Subjective Global Assessment predicts hospital stay in patients with digestive diseases[J]. Nutrition, 2007, 23(9): 634-639. DOI: 10.1016/j.nut.2007.06.005.
    [19]
    GUPTA D, VASHI PG, LAMMERSFELD CA, et al. Role of nutritional status in predicting the length of stay in cancer: A systematic review of the epidemiological literature[J]. Ann Nutr Metab, 2011, 59(2-4): 96-106. DOI: 10.1159/000332914.
    [20]
    SOMMACAL HM, BERSCH VP, VITOLA SP, et al. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: A randomized, double-blind clinical trial[J]. Nutr Cancer, 2015, 67(3): 457-462. DOI: 10.1080/01635581.2015.1004734.
    [21]
    KANAZAWA H, NAGINO M, KAMIYA S, et al. Synbiotics reduce postoperative infectious complications: A randomized controlled trial in biliary cancer patients undergoing hepatectomy[J]. Langenbecks Arch Surg, 2005, 390(2): 104-113. DOI: 10.1007/s00423-004-0536-1.
    [22]
    KRVGER J, MEFFERT PJ, VOGT LJ, et al. Early parenteral nutrition in patients with biliopancreatic mass lesions, a prospective, randomized intervention trial[J]. PLoS One, 2016, 11(11): e0166513. DOI: 10.1371/journal.pone.0166513.
    [23]
    JO S, CHOI SH, HEO JS, et al. Missing effect of glutamine supplementation on the surgical outcome after pancreaticoduodenectomy for periampullary tumors: A prospective, randomized, double-blind, controlled clinical trial[J]. World J Surg, 2006, 30(11): 1974-1982; discussion 1983-1984. DOI: 10.1007/s00268-005-0678-5.
    [24]
    SHI HP, XU HX, LI SY, et al. Five-stepped therapy for malnutrition[J/CD]. Electronic J Metabol Nutr Cancer, 2015, 2(1): 29-33.

    石汉平, 许红霞, 李苏宜, 等. 营养不良的五阶梯治疗[J/CD]. 肿瘤代谢与营养电子杂志, 2015, 2(1): 29-33.
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