PRE AND POSTOPERATIVE MAINTENANCE OF NUTRITIONAL STATUS IN PATIENTS WITH COMPLICATED PORTAL HYPERTENSION (ESOPHAGOGASTRIC VARICEAL BLEEDING) IN LIVER CIRRHOSIS: A RETROSPECTIVE STUDY andrii.dinets@gmail.com

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PRE AND POSTOPERATIVE MAINTENANCE OF NUTRITIONAL STATUS IN PATIENTS WITH COMPLICATED PORTAL HYPERTENSION (ESOPHAGOGASTRIC VARICEAL BLEEDING) IN LIVER CIRRHOSIS: A RETROSPECTIVE STUDY

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Ukraine

Oral only

Esophageal and gastric variceal bleeding in patients with liver cirrhosis is associated with high morbidity and mortality. Nutritional support in the post-hemorrhagic and postoperative periods is critical, yet often delayed. This study assessed the safety and efficacy of early enteral protein nutrition (EEPN) in stabilizing protein metabolism

A 71 patients were analyzed diagnosis of cirrhosis and variceal bleeding who underwent emergency surgery after hemodynamic stabilization. Group 1 (n=34; 2020–2024) received EEPN starting 24 hours post-bleeding and day 2 post-surgery. Group 2 (n=37; 2015–2019) received parenteral nutrition, initiating enteral nutrition from day 6. Surgical management included porto-azygous devascularization and, if needed, splenectomy. Laboratory markers (total protein, albumin) and postoperative outcomes were monitored up to 6 months.

Both groups showed postoperative decreases in protein markers; however, Group 1 demonstrated significantly faster recovery of total protein and albumin (p<0.05), fewer postoperative complications (ascites, pneumonia, encephalopathy), and reduced hospital stay (9.7±1.3 vs. 14.6±2.3 days). EEPN did not increase the risk of rebleeding.

Early enteral protein nutrition is a safe and effective approach for postoperative support in cirrhotic patients with variceal bleeding. It improves protein synthesis, reduces catabolism, shortens hospitalization, and decreases complication rates. EEPN should be considered a priority in nutritional strategies post-variceal bleeding surgery.