Comparison of different feeding regimes after pancreatoduodenectomy - a retrospective cohort analysis

Delayed gastric emptying (DGE) is the most frequent pancreatic specific complication (PSC) after pancreaticoduodenectomy (PD). Several gastric decompression systems exist to manage DGE. Patients with a pancreatic tumor require prolonged nutrition; however, controversies exist concerning nutrition pr...

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Bibliographic Details
Published in:Nutrition journal 2017-07, Vol.16 (1), p.42-42, Article 42
Main Authors: Guilbaud, Théophile, Birnbaum, David Jérémie, Loubière, Sandrine, Bonnet, Julien, Chopinet, Sophie, Grégoire, Emilie, Berdah, Stéphane, Hardwigsen, Jean, Moutardier, Vincent
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Body mass index
Cohort analysis
Cost savings
Decompression
Delayed gastric empty
Enteral nutrition
Enteral Nutrition - economics
Feeding regimes
Female
Follow-Up Studies
Gastric Bypass
Gastric emptying
Gastrojejunostomy tube
Gastrostomy
Hospitals
Humans
Intubation
Intubation, Gastrointestinal
Jaundice
Length of Stay - economics
Male
Middle Aged
Morbidity
Mortality
Multivariate analysis
Nutrition
Nutritional Support - methods
Ostomy
Pancreas
Pancreatic cancer
Pancreatic Neoplasms - economics
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - therapy
Pancreaticoduodenectomy
Parenteral nutrition
Parenteral Nutrition, Total - economics
Patients
Postoperative Complications - economics
Postoperative Complications - epidemiology
Postoperative Complications - therapy
Postoperative pancreatic fistula
Retrospective Studies
Risk Factors
Surgery
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Summary:Delayed gastric emptying (DGE) is the most frequent pancreatic specific complication (PSC) after pancreaticoduodenectomy (PD). Several gastric decompression systems exist to manage DGE. Patients with a pancreatic tumor require prolonged nutrition; however, controversies exist concerning nutrition protocol after PD. The aim of the study was to assess the safety and efficacy of nasogastric (NG), gastrostomy (GT), and gastrojejunostomy (GJ) tubes with different feeding systems on postoperative courses. Between January 2013 and March 2016, 86 patients underwent PD with pancreaticogastrostomy. Patients were divided into three groups: GJ group with enteral nutrition (EN, n = 12, 14%), NG (n = 31, 36%) and GT groups (n = 43, 50%), both with total parenteral nutrition (TPN). Patients in the GJ (n = 9, 75%) and GT (n = 18, 42%) groups had an American Society of Anesthesiologists (ASA) score of 3 more often than those in the NG group (n = 5, 16%, p ≤ 0.01). Multivariate analysis identified the GT tube with TPN as an independent risk factor of severe morbidity (p = 0.02) and DGE (p 
ISSN:1475-2891
1475-2891
DOI:10.1186/s12937-017-0265-2