The effects of liver dysfunction and portal hypertension on intestinal adaptation in short bowel syndrome are generally unknown.
These disorders may affect the ability to wean these patients from parenteral nutrition.
In this study, published in the December issue of the American Journal of Surgery, 42 infants with short bowel syndrome were assessed.
They were assigned to 1 of 3 Child's classifications, depending on serum bilirubin, prothrombin time, ascites, albumin, and liver biopsy.
They were then compared for time to diet tolerance, time required for parenteral nutrition, and survival.
|Survival for Child's class A was 100%, class B was 84%, and C 61%.|
|American Journal of Surgery|
A subgroup of these patients also underwent portal pressure measurement, which was combined with liver biopsy results to compare three groups for the same parameters.
The team found that survival for Child's class A was 100%, class B was 84%, and C 61%.
Time to feeding tolerance was 16.3 days for Child's class A, 20 days for class B, and 28 days for class C.
In addition, total parenteral nutrition time was 80 days for class A, 98 days for class B, and 100 days for class C.
In the subgroups that underwent portal pressure measurement, the team found that survival was 100% for group 1 (normal biopsy and pressure), 90% for group 2 (abnormal biopsy and normal pressure), and 66% for group 3 (abnormal biopsy and pressure).
They also found that time to feeding tolerance was 15 days for group 1, 18 days for group 2, and 24 days for group 3.
Total parenteral nutrition time was 72 days for group 1, 94 for group 2 and 184 for group 3.
Dr Thomas Webber and Dr Martin Keller concluded, "Cholestatic liver disease, especially associated with portal hypertension adversely affects bowel adaptation in short bowel syndrome".