[Present state and views of nutritional management in abdominal surgery. 5. Pre and postoperative nutritional management of various diseases. (b) Hepatobiliary-pancreatic disease].

The field of hepatobiliary-pancreatic surgery involves performing hepatectomy, pancreatectomy, and hepatopancreatoduodenectomy, which are all very invasive procedures. Since bile and pancreatic juice are associated with the etiology of disease, appropriate management is necessary for patients with chronic hepatitis, liver cirrhosis, obstructive jaundice, deteriorating internal and external secretory function of the pancreas and digestive organs, and absorption disorders. Because malnutrition increases the risk of postoperative morbidity and mortality, it is important for patients to maintain good nutritional status during the perioperative period to improve the postoperative outcome. Recently, the efficacy of branched-chain amino acid administration for liver cirrhosis, bile replacement for obstructive jaundice, early enteral nutrition, immunonutrition, and synbiotics has been reported and therefore these management approaches should be considered carefully in patients undergoing hepatobiliary-pancreatic surgery.