Meta‐analysis of effect of routine enteral nutrition on postoperative outcomes after pancreatoduodenectomy.
Published: 26th June 2019
Authors: M. Tanaka, M. Heckler, A. L. Mihaljevic, P. Probst, U. Klaiber, U. Heger et al.
The optimal nutritional treatment after pancreatoduodenectomy is still unclear. The aim of this meta‐analysis was to investigate the impact of routine enteral nutrition following pancreatoduodenectomy on postoperative outcomes.
RCTs comparing enteral nutrition (regular oral intake with routine tube feeding) with non‐enteral nutrition (regular oral intake with or without parenteral nutrition) after pancreatoduodenectomy were sought systematically in the MEDLINE, Cochrane Library and Web of Science databases. Postoperative data were extracted. Random‐effects meta‐analyses were performed to compare postoperative outcomes in the two arms, and pooled odds ratios (ORs) or mean differences (MDs) were calculated with 95 per cent confidence intervals. In subgroup analyses, the routes of nutrition were assessed. Percutaneous tube feeding and nasojejunal tube feeding were each compared with parenteral nutrition.
Eight RCTs with a total of 955 patients were included. Enteral nutrition was associated with a lower incidence of infectious complications (OR 0·66, 95 per cent c.i. 0·43 to 0·99; P = 0·046) and a shorter length of hospital stay (MD –2·89 (95 per cent c.i. –4·99 to –0·80) days; P < 0·001) than non‐enteral nutrition. Percutaneous tube feeding had a lower incidence of infectious complications (OR 0·47, 0·25 to 0·87; P = 0·017) and a shorter hospital stay (MD –1·56 (–2·13 to –0·98) days; P < 0·001) than parenteral nutrition (3 RCTs), whereas nasojejunal tube feeding was not associated with better postoperative outcomes (2 RCTs).
As a supplement to regular oral diet, routine enteral nutrition, especially via a percutaneous enteral tube, may improve postoperative outcomes after pancreatoduodenectomy.Full text
You may also be interested in
Authors: L. Scholten, T. F. Stoop, M. Del Chiaro, O. R. Busch, C. van Eijck, I. Q. Molenaar et al.
Multicentre observational cohort study of implementation and outcomes of laparoscopic distal pancreatectomy.
Authors: S. Lof, A. L. Moekotte, B. Al‐Sarireh, B. Ammori, S. Aroori, D. Durkin et al.
Authors: M. Tanaka, A. L. Mihaljevic, P. Probst, M. Heckler, U. Klaiber, U. Heger et al.
Multicentre analysis of the learning curve for laparoscopic liver resection of the posterosuperior segments. BJS 2019; 106: 1512-1522.
Authors: G. Berardi, D. Aghayan, Å. A. Fretland, H. Elberm, F. Cipriani, A. Spagnoli et al.
Validation of a nomogram to predict the risk of cancer in patients with intraductal papillary mucinous neoplasm and main duct dilatation of 10 mm or less.
Authors: W. Jung, T. Park, Y. Kim, H. Park, Y. Han, J. He et al.
Secondary technical resectability of colorectal cancer liver metastases after chemotherapy with or without selective internal radiotherapy in the randomized SIRFLOX trial.
Authors: B. Garlipp, P. Gibbs, G. A. Van Hazel, R. Jeyarajah, R. C. G. Martin, C. J. Bruns et al.
Benign hilar bile duct strictures resected as perihilar cholangiocarcinoma. BJS 2019; 106: 1504-1511.
Authors: S. Otsuka, T. Ebata, Y. Yokoyama, T. Igami, T. Mizuno, J. Yamaguchi et al.
Meta‐analysis of the association between primary tumour location and prognosis after surgical resection of colorectal liver metastases.
Authors: X.‐Y. Wang, R. Zhang, Z. Wang, Y. Geng, J. Lin, K. Ma et al.
Authors: N. Filmann, D. Walter, E. Schadde, C. Bruns, T. Keck, H. Lang et al.
Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.
Authors: Å. A. Fretland, V. J. Dagenborg, G. M. Waaler Bjørnelv, D. L. Aghayan, A. M. Kazaryan, L. Barkhatov et al.
Safety and efficacy of transarterial embolization of hepatocellular adenomas. BJS 2019; 106: 1362-1371.
Authors: B. V. van Rosmalen, A. J. Klompenhouwer, J. Jaap de Graeff, M. P. D. Haring, V. E. de Meijer, L. Rifai et al.
Authors: A. Pulvirenti, A. Pea, N. Rezaee, C. Gasparini, G. Malleo, M. J. Weiss et al.