Description

A person who is receiving total parenteral nutrition (TPN) is at risk for a disorder of the gallbladder. A person at high risk may benefit from more aggressive management to target risk factors.


 

Types of gallbladder dysfunction:

(1) acalculous cholecystitis

(2) cholecystitis associated with sludge and/or cholelithiasis

(3) decreased emptying with distention

 

Risk factors:

(1) ileal disease and/or ileal resection

(2) short bowel syndrome

(3) duration of TPN > 3 weeks

(4) no oral intake

(5) prolonged fast

(6) pre-existing gallbladder disease

(7) administration of narcotics or anticholinergic drugs

 

Risk reduction:

(1) providing some oral intake

(2) administration of cholecystokinin (CCK) under selected circumstances

(3) avoidance of narcotics and anticholinergic agents

 


To read more or access our algorithms and calculators, please log in or register.