To investigate the clinical application value of early enteral nutrition after laparoscopic hepatectomy for hepatocellular carcinoma (HCC).

A total of 49 patients with HCC undergoing laparoscopic hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between November 2013 and June 2014 were included in this prospective study. These patients were divided into the enteral nutrition group and the parenteral nutrition group according to the random number table method. Twenty-five patients were divided into the enteral nutrition group, among them, 20 were males and 5 were females with the average age of (49±17) years old. Twenty-four patients were divided into the parenteral nutrition group, among them, 18 were males and 6 were females with the average age of (51±14) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients in the enteral nutrition group were given Ensure nutrient solution orally 24 h after operation for 7 d and the patients in the parenteral nutrition group were given parenteral nutrition 24 h after operation for 7 d. The total human albumin supplemented volume, recover time of gastrointestinal function, length of hospital stay after operation and hospitalization expenses of the two groups were compared. The nutritional support associated complications were observed. The data of the two groups were compared using t test or Wilcoxon rank-sum test.

The total human albumin supplemented volume after operation of the enteral nutrition group was (40±11) g, which was significantly lower than (45±10) g of the parenteral nutrition group(t=-16.089, P<0.05). The recovery time of gastrointestinal function after operation of the enteral nutrition group was (25±8) h, which was significantly shorter than (43±11) h of the parenteral nutrition group (t=-36.928, P<0.05). The length of hospital stay after hepatectomy of the enteral nutrition group was (8±2) d, which was significantly lower than (10±3) d of parenteral nutrition group (t=-12.025, P<0.05). The total hospitalization expenses of the enteral nutrition group were RMB 45,000 (37,000-61,000) yuan, which were significantly lower than RMB 49,000 (42,000-67,000) yuan of the parenteral nutrition group (Z=-18.495, P<0.05). Five patients in the enteral nutrition group and 8 patients in the parenteral nutrition group developed abdominal distention and diarrhea, which were alleviated by adjusting doses or infusion speed.

Early enteral nutrition after laparoscopic hepatectomy for HCC is beneficial to the postoperative recovery of gastrointestinal function and may effectively reduce the financial burden of patients. Moreover, its overall curative effect is better than that of parenteral nutrition.