Effects of Perioperative Synbiotic Treatment on Infectious Complications, Intestinal Integrity, and Fecal Flora and Organic Acids in Hepatic Surgery With or Without Cirrhosis

Background: The aim of this study was to assess the effect of preoperative and postoperative synbiotic treatment in hepatectomy patients with or without liver cirrhosis. Methods: Sixty-one patients with hepatic cancer were assigned randomly to receive either oral synbiotics that consisted of Bifidobacterium, Lactobacillus, and galactooligosaccharides or no synbiotics (control) preoperatively for 14 days and postoperatively for 11 days. Infectious complications, intestinal mucosal integrity as measured by serum diamine oxidase (DAO) activity, and fecal flora and organic acid concentrations were compared between synbiotic treatment (n = 32) and control (n = 29) groups. Results: Fecal flora culture and organic acid concentrations were changed after hepatectomy in both groups. The postsurgery decrease in DAO activity was less profound in the synbiotic-treated group (P <.01) and was correlated negatively with serum interleukin 6 and C-reactive protein concentrations (P <.001). Infectious complications occurred in 5 (17.2%) patients in the control group and no patients in the synbiotic-treated group (P <.05). Conclusion: Perioperative synbiotic treatment attenuated the decrease in intestinal integrity and reduced the rate of infectious complications in patients with or without liver cirrhosis who underwent hepatic surgery. (JPEN J Parenter Enteral Nutr. 2011; 35: 317-328)