Document Detail


Early oral feeding after pancreatoduodenectomy enhances recovery without increasing morbidity.
MedLine Citation:
PMID:  24308458     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to evaluate whether a change in the routine feeding strategy applied after pancreatoduodenectomy (PD) from nasojejunal tube (NJT) feeding to early oral feeding improved clinical outcomes.
METHODS: An observational cohort study was performed in 102 consecutive patients undergoing PD. In period 1 (n = 51, historical controls), the routine postoperative feeding strategy was NJT feeding. This was changed to a protocol of early oral feeding with on-demand NJT feeding in period 2 (n = 51, consecutive prospective cohort). The primary outcome was time to resumption of adequate oral intake.
RESULTS: The baseline characteristics of study subjects in both periods were comparable. In period 1, 98% (n = 50) of patients received NJT feeding, whereas in period 2, 53% (n = 27) of patients did so [for delayed gastric empting (DGE) (n = 20) or preoperative malnutrition (n = 7)]. The time to resumption of adequate oral intake significantly decreased from 12 days in period 1 to 9 days in period 2 (P = 0.015), and the length of hospital stay shortened from 18 days in period 1 to 13 days in period 2 (P = 0.015). Overall, there were no differences in the incidences of complications of Clavien-Dindo Grade III or higher, DGE, pancreatic fistula, postoperative haemorrhage and mortality between the two periods.
CONCLUSIONS: The introduction of an early oral feeding strategy after PD reduced the time to resumption of adequate oral intake and length of hospital stay without negatively impacting postoperative morbidity.
Authors:
Arja Gerritsen; Roos A W Wennink; Marc G H Besselink; Hjalmar C van Santvoort; Dorine S J Tseng; Elles Steenhagen; Inne H M Borel Rinkes; I Quintus Molenaar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-6
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  -     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 International Hepato-Pancreato-Biliary Association.
Affiliation:
Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.
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