J Korean Med Sci.  2012 Mar;27(3):261-267. 10.3346/jkms.2012.27.3.261.

Postoperative Nutritional Effects of Early Enteral Feeding Compared with Total Parental Nutrition in Pancreaticoduodectomy Patients: A Prosepective, Randomized Study

• Park JS
• Chung HK
• Hwang HK
• Kim JK
• Yoon DS

• KMID: 1792996
• DOI: http://doi.org/10.3346/jkms.2012.27.3.261

Abstract

The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.

Keyword

Early Enetral Feeding; TPN; Nutrition; Pancreaticoduodenectomy

MeSH Terms

Aged
Carcinoma, Pancreatic Ductal/physiopathology/surgery/therapy
Digestive System/physiopathology
*Enteral Nutrition/adverse effects
Female
Humans
Male
Middle Aged
Nutritional Status
Pancreatic Neoplasms/physiopathology/surgery/therapy
*Pancreaticoduodenectomy/adverse effects
*Parenteral Nutrition, Total
Postoperative Care/*methods
Postoperative Period
Prospective Studies
Time Factors
Treatment Outcome
Weight Gain

Figure

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  Fig. 1 Study outline.

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  Fig. 2 Trial profile.

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  Fig. 3 Mean prealbumin and transferring levels on preoperative day and on days 7, 14, 21, and 90 postoperatively*. Error bars: 95% confidence interval. *There was significant difference between the EEN and TPN Group at any time point of postoperative days.

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