The effect of total parenteral nutrition (TPN) with fat emulsion was evaluated in 20 patients with liver disorders who showed Diabetes Mellitus (DM) type in preoperative oral glucose tolerance test (OGTT). The patients were divided into two groups according to Child's classification (Child A group; 10 cases, Child B group; 10 cases) and they underwent TPN after direct operation for esophageal varices. Blood glucose level in Child B group in the first to third days after operation was over 190 mg/dl and it was higher than that of Child A group during TPN. But blood glucose level of fat containing TPN cases in both groups tended to be lower than that of fat free TPN cases. There was no abnormal finding in liver function tests during TPN with or without fat emulsion after operation. It was indicated that fat containing TPN had little influences on the liver function in patients with liver disorders such as Child A and B who were classified in DM type in preoperative OGTT. Serum essential fatty acids level before operation was lower than normal level, and it further decreased after operation. The decrease was inhibited in patients of both groups undergoing TPN with fat emulsion. The plasma removal rates of fat emulsion (K2 values) during postoperative TPN were higher than those in preoperative period.It is concluded that the administration of fat emulsion is available to the patients with liver disorder accompanied with DM in OGTT during postoperative TPN.
