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document
Hepatobiliary response in postoperative lipid therapy in gastrointestinal surgery . BACKGROUND/AIMS Intravenous lipid emulsions may contribute to the development of total parenteral nutrition ( TPN ) -- induced hepatobiliary complications . METHODS In a prospective , randomised setting the authors compared the short-term hepatic effects of medium-chain triglycerides/short-chain triglycerides ( MCT/LCT ) physical mixture with a four-component intravenous ( i.v . ) lipid emulsion ( LCT , MCT , Olive-oil and Fish-oil ) in patients undergoing elective gastrointestial surgery during the early postoperative period . RESULTS The authors demonstrated that total and conjugated bilirubin , alkaline phosphatase , alanine aminotransferase , aspartate amino transferase and cholinesterase did not change significantly during the 5-days observation period . In contrast to this , gamma-glutamyl transferase ( GGT ) activity increased by 2,4 times during 5-days therapy with the lipid emulsions mentioned above ( SMOF lipid : 21,9 to 52,9 U/L , Lipofundin : from 32,5 to 79,6 U/L ) . CONCLUSION during a 4-days administration hepatic effect of the intravenous lipid emulsions did not differ significantly . The changes in enzyme levels confirm the cholestatic type of hepatobiliary deviations without clinical impact on short-term TPN therapy .
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Intervention_Pharmacological
lipid therapy
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Intervention_Pharmacological
lipid emulsions
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Intervention_Pharmacological
medium-chain triglycerides/short-chain triglycerides ( MCT/LCT ) physical mixture with a four-component intravenous ( i.v . ) lipid emulsion ( LCT , MCT , Olive-oil and Fish-oil )
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Intervention_Pharmacological
therapy with the lipid emulsions
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Intervention_Pharmacological
lipid emulsions
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Intervention_Pharmacological
TPN therapy
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Outcome_Physical
Hepatobiliary response
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Outcome_Physical
total and conjugated bilirubin
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Outcome_Physical
alkaline phosphatase
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Outcome_Physical
alanine aminotransferase
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Outcome_Physical
aspartate amino transferase and cholinesterase
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Outcome_Physical
gamma-glutamyl transferase ( GGT ) activity
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Outcome_Physical
changes in enzyme levels