Influences of oral administration of probiotics on postoperative infection and liver function recovery in patients with partial hepatectomy

doi:10.3969/j.issn.1674-8115.2022.01.002

Abstract

Abstract: Objective

·To investigate the influences of oral administration of probiotics on postoperative infection and liver function recovery in patients with partial hepatectomy.

Methods

·A total of 165 patients undergoing partial hepatectomy in Shanghai General Hospital, Shanghai Jiao Tong University, were involved in this prospective randomized control study. In accordance with the random number table, patients were divided into mechanical bowel preparation group (MBP group, n=55), non-bowel preparation group (NBP group, n=55) and probiotics bowel preparation group (PBP group, n=55). Patients' general information, postoperative fever, the first time of flatus and defecation, and infectious indexes and liver function indexes on the 1st,3rd and 5th day after operation were collected and compared among the groups.

Results

·There was no significant difference in the basic data among the 3 groups (all P>0.05). On the 5th day after operation, the white blood count of the PBP group was significantly lower than that of the MBP group (P=0.012) and NBP group (P=0.029). The level of glutamic-pyruvic transaminase of the PBP group was significantly lower than that of the MBP group and NBP group on the 3rd day (P=0.040, P=0.036) and the 5th day (P=0.002, P=0.019) after operation.

Conclusion

·Oral probiotics intestinal preparation is helpful to reduce infection after partial hepatectomy and accelerate the recovery of liver function.

Key words: partial hepatectomy, bowel preparation, probiotics, postoperative infection, liver function

CLC Number:

R473.6

Yi WU, Fang FANG, Hao HUANG, Ying CHEN. Influences of oral administration of probiotics on postoperative infection and liver function recovery in patients with partial hepatectomy[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2022, 42(1): 9-15.

Figures/Tables 4

TrendMD

References 22

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Item	MBP group （n=55）	NBP group （n=55）	PBP group （n=55）	P value
Gender/n				0.420
Male	43	37	41
Female	12	18	14
Age/n				0.887
≥60 years	22	24	20
<60 years	33	31	35
BMI/（kg·m^-2）	23.88±0.44	23.30±0.44	23.70±0.45	0.553
Liver cirrhosis/n				0.399
Yes	28	32	35
No	27	23	20
MELD score	47.28±1.64	53.97±4.20	52.25±4.18	0.415
Serum total bilirubin/（μmol·L^-1）	20.06±0.88	23.69±4.27	22.63±4.23	0.765
Serum albumin/（g·L^-1）	38.69±0.60	40.14±0.58	39.30±0.67	0.261
PT/s	11.77±0.14	11.46±0.10	11.63±0.13	0.180
INR	0.98±0.01	0.96±0.01	0.96±0.01	0.207
Serum creatinine/（μmol·L^-1）	67.21±1.77	72.33±3.54	68.64±3.30	0.459
White blood count/（×10⁹·L^-1）	7.26±0.56	7.18±0.57	7.27±0.57	0.992
Resected liver volume exceeded 30%/n				0.303
Yes	22	25	30
No	33	30	25
Operation time/min	187.60±8.60	181.40±9.43	197.50±9.86	0.457

Item	MBP group （n=55）	NBP group （n=55）	PBP group （n=55）	P value
Gender/n				0.420
Male	43	37	41
Female	12	18	14
Age/n				0.887
≥60 years	22	24	20
<60 years	33	31	35
BMI/（kg·m^-2）	23.88±0.44	23.30±0.44	23.70±0.45	0.553
Liver cirrhosis/n				0.399
Yes	28	32	35
No	27	23	20
MELD score	47.28±1.64	53.97±4.20	52.25±4.18	0.415
Serum total bilirubin/（μmol·L^-1）	20.06±0.88	23.69±4.27	22.63±4.23	0.765
Serum albumin/（g·L^-1）	38.69±0.60	40.14±0.58	39.30±0.67	0.261
PT/s	11.77±0.14	11.46±0.10	11.63±0.13	0.180
INR	0.98±0.01	0.96±0.01	0.96±0.01	0.207
Serum creatinine/（μmol·L^-1）	67.21±1.77	72.33±3.54	68.64±3.30	0.459
White blood count/（×10⁹·L^-1）	7.26±0.56	7.18±0.57	7.27±0.57	0.992
Resected liver volume exceeded 30%/n				0.303
Yes	22	25	30
No	33	30	25
Operation time/min	187.60±8.60	181.40±9.43	197.50±9.86	0.457

Item	MBP group （n=55）	NBP group （n=55）	PBP group （n=55）	P value
White blood count/（×10⁹·L^-1）
Postoperative day 1	14.55±0.63	13.82±0.64	14.25±0.64	0.592
Postoperative day 3	10.67±0.56^①	9.61±0.46	9.22±0.37	0.046
Postoperative day 5	8.13±0.38^②	8.09±0.38^③	7.11±0.29	0.031
Blood neutrophils count/（×10⁹·L^-1）
Postoperative day 1	12.69±0.61	12.10±0.61	12.53±0.62	0.671
Postoperative day 3	24.47±15.63	23.60±15.64	7.42±0.36	0.571
Postoperative day 5	5.76±0.32	5.42±0.29	5.33±0.26	0.442
Procalcitonin/（ng·mL^-1）
Postoperative day 1	1.99±0.86	1.90±0.86	2.59±1.17	0.523
Postoperative day 3	4.36±3.23	1.08±0.31	1.24±0.41	0.380
Postoperative day 5	0.48±0.01	1.33±0.85	1.43±0.86	0.576
Fungal D-glucan/（pg·mL^-1）
Postoperative day 1	220.40±48.73	227.80±48.64	267.50±64.25	0.562
Postoperative day 3	199.40±60.97	181.40±47.31	198.40±48.33	0.890
Postoperative day 5	124.10±35.40	101.70±25.88	132.40±33.91	0.545
Endotoxin limulus test/（EU·mL^-1）
Postoperative day 1	21.24±14.78	10.68±10.55	10.69±10.55	0.371
Postoperative day 3	1.49±1.32	1.46±1.32	0.19±0.06	0.627
Postoperative day 5	0.25±0.07	0.18±0.05	0.19±0.05	0.311
Interleukin-6/（pg·mL^-1）
Postoperative day 1	233.70±68.50	191.70±51.60	139.20±50.48	0.118
Postoperative day 3	98.97±17.68	96.41±16.44	103.40±20.89	0.877
Postoperative day 5	39.76±5.10	44.57±5.98	43.06±6.24	0.786

Item	MBP group （n=55）	NBP group （n=55）	PBP group （n=55）	P value
White blood count/（×10⁹·L^-1）
Postoperative day 1	14.55±0.63	13.82±0.64	14.25±0.64	0.592
Postoperative day 3	10.67±0.56^①	9.61±0.46	9.22±0.37	0.046
Postoperative day 5	8.13±0.38^②	8.09±0.38^③	7.11±0.29	0.031
Blood neutrophils count/（×10⁹·L^-1）
Postoperative day 1	12.69±0.61	12.10±0.61	12.53±0.62	0.671
Postoperative day 3	24.47±15.63	23.60±15.64	7.42±0.36	0.571
Postoperative day 5	5.76±0.32	5.42±0.29	5.33±0.26	0.442
Procalcitonin/（ng·mL^-1）
Postoperative day 1	1.99±0.86	1.90±0.86	2.59±1.17	0.523
Postoperative day 3	4.36±3.23	1.08±0.31	1.24±0.41	0.380
Postoperative day 5	0.48±0.01	1.33±0.85	1.43±0.86	0.576
Fungal D-glucan/（pg·mL^-1）
Postoperative day 1	220.40±48.73	227.80±48.64	267.50±64.25	0.562
Postoperative day 3	199.40±60.97	181.40±47.31	198.40±48.33	0.890
Postoperative day 5	124.10±35.40	101.70±25.88	132.40±33.91	0.545
Endotoxin limulus test/（EU·mL^-1）
Postoperative day 1	21.24±14.78	10.68±10.55	10.69±10.55	0.371
Postoperative day 3	1.49±1.32	1.46±1.32	0.19±0.06	0.627
Postoperative day 5	0.25±0.07	0.18±0.05	0.19±0.05	0.311
Interleukin-6/（pg·mL^-1）
Postoperative day 1	233.70±68.50	191.70±51.60	139.20±50.48	0.118
Postoperative day 3	98.97±17.68	96.41±16.44	103.40±20.89	0.877
Postoperative day 5	39.76±5.10	44.57±5.98	43.06±6.24	0.786

Item	MBP group （n=55）	NBP group （n=55）	PBP group （n=55）	P value
GPT/（U·L^-1）
Postoperative day 1	310.70±28.12	274.70±27.08	296.60±28.80	0.509
Postoperative day 3	215.30±21.56^①	216.70±22.19^②	156.60±18.66	0.043
Postoperative day 5	109.10±8.74^③	119.50±13.06^④	83.36±7.47	0.017
GOT/（U·L^-1）
Postoperative day 1	313.70±25.47	291.00±25.33	310.90±27.29	0.700
Postoperative day 3	105.20±10.11	119.70±14.33	97.34±8.59	0.294
Postoperative day 5	48.13±3.20	51.30±5.93	41.72±3.18	0.229
Serum total bilirubin/（μmol·L^-1）
Postoperative day 1	23.09±1.70	26.51±3.12	24.36±2.91	0.652
Postoperative day 3	23.21±1.42	25.45±2.38	24.89±2.38	0.733
Postoperative day 5	21.19±1.30	23.24±1.92	21.56±1.87	0.639
Serum direct bilirubin/（μmol·L^-1）
Postoperative day 1	8.49±1.01	9.99±1.86	9.49±1.73	0.778
Postoperative day 3	8.84±0.68	9.66±1.21	9.42±1.20	0.848
Postoperative day 5	7.18±0.52	7.73±0.84	7.76±0.84	0.808
PT/s
Postoperative day 1	13.02±0.18	12.77±0.18	12.77±0.20	0.379
Postoperative day 3	13.06±0.19^⑤	12.87±0.18^⑥	12.39±0.18	0.011
Postoperative day 5	12.81±0.17^⑦	12.37±0.27	11.75±0.33	0.007
INR
Postoperative day 1	1.09±0.02	1.06±0.02	1.37±0.29	0.382
Postoperative day 3	1.09±0.02	1.08±0.02	1.05±0.01	0.082
Postoperative day 5	1.08±0.01	1.06±0.01	1.04±0.01	0.115