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pancreatoduodenectomy early enteral nutrition

Orlando Jorge M Torres, Eduardo de Souza M Fernandes, Rodrigo Rodrigues Vasques, Fabio Luís Waechter, Paulo Cezar G Amaral, Marcelo Bruno de Rezende, Roland Montenegro Costa, André Luís Montagnini
BACKGROUND: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. AIM: To understand the Brazilian practice patterns for pancreatoduodenectomy. METHOD: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Z A Kovalenko, V K Lyadov, K V Lyadov
AIM: To assess safety and clinical-economic effectiveness of complex postoperative rehabilitation after pancreatoduodenectomy. MATERIAL AND METHODS: 73 patients were included in the study. Main group consisted of 39 patients who underwent accelerated postoperative rehabilitation that was developed in our clinic. In the control group of 34 patients this protocol was not applied. The main components of rehabilitation were multicomponent analgesia, early enteral nutrition, physical rehabilitation by using of exercise therapy and physiotherapy...
2017: Khirurgiia
Federico Bozzetti, Luigi Mariani
OBJECTIVE: The results achieved through the Enhanced Recovery After Surgery (ERAS) approach in gastrointestinal surgery have led to its enthusiastic acceptance in pancreatic surgery. However, the ERAS program also involves an early oral feeding that is not always feasible after pancreatoduodenectomy. The aim of this review was to investigate in the literature whether the difficulty with early oral feeding in these patients was adequately balanced by perioperative enteral or parenteral nutritional support as recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines or whether these recommendations have lost value in the "bundle" of the ERAS...
November 2014: Nutrition
Toshiaki Aida, Katsunori Furukawa, Daisuke Suzuki, Hiroaki Shimizu, Hiroyuki Yoshidome, Masayuki Ohtsuka, Atsushi Kato, Hideyuki Yoshitomi, Masaru Miyazaki
BACKGROUND: An immune-enhancing diet has been used to alter eicosanoid synthesis, cytokine production, and immune function in an attempt to limit the undesired immune reactions after injury from surgery. This prospective randomized study was designed to investigate the effect of preoperative immunonutrition on operative complications, and the participation of prostaglandin E2 (PGE2) on T-cell differentiation in patients undergoing a severely stressful surgery. METHODS: The enrolled patients who were scheduled to undergo pancreatoduodenectomy were randomized into two groups...
January 2014: Surgery
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
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)...
July 2014: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Mohammed Abu Hilal, David M Layfield, Francesco Di Fabio, Irantzu Arregui-Fresneda, Ioanna G Panagiotopoulou, Thomas H Armstrong, Neil W Pearce, Colin D Johnson
BACKGROUND: Chyle leak complicates 1.3-10.8 % of pancreatic resections. Universal use of parenteral nutrition following pancreatic resection may reduce the incidence of chyle leak. However, this denies the majority of patients who do not develop chyle leak the benefits of enteral nutrition (EN). The present study aimed to identify risk factors for chyle leak following pancreatic resection within a single institution where EN was used universally. METHODS: All patients who underwent pancreatic resection between January 2007 and December 2010 were identified retrospectively...
December 2013: World Journal of Surgery
Yinfeng Shen, WenYin Jin
PURPOSE: The aim of our study was to evaluate the safety and effectiveness of early enteral nutrition (EN) for patients after pancreatoduodenectomy (PD). METHODS: We performed a comprehensive search of abstracts in the MEDLINE database, OVID database, Springer database, the Science Citation Index, and the Cochrane Library database. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of early EN and other nutritional routes for patients after PD were analyzed...
August 2013: Langenbeck's Archives of Surgery
Seiji Haji, Harumasa Ohyanagi, Yoshifumi Takeyama
Pancreatoduodenectomy is one of the most invasive and complex procedures in gastrointestinal surgery. Perioperative nutritional management, particularly enteral nutrition, is essential for patients undergoing pancreatoduodenectomy to attenuate postoperative complications and avoid progression of malnutrition due to surgical stress. Early enteral nutrition including immunonutrition via catheter jejunostomy is recommended from the viewpoint of protection from postoperative complications. If inadequate caloric administration via enteral nutrition alone cannot be achieved, combined enteral and parenteral nutrition is warranted...
January 2010: Nihon Geka Gakkai Zasshi
Takehiro Okabayashi, Hiromichi Maeda, Isao Nishimori, Takeki Sugimoto, Tatsuo Ikeno, Kazuhiro Hanazaki
BACKGROUND/AIMS: The operative mortality and morbidity associated with pancreatoduodenectomy (PD) has been decreasing, however, pancreatic fistula remains a major cause of a potentially fatal complication. The aim of this study was to identify risk factors, predictors and prevention for pancreatic fistula formation in a consecutive series of PD cases in a single institution. METHODOLOGY: The association between pancreatic fistula formation and various clinical parameters was investigated in 100 patients who underwent PD at Kochi Medical School from April 1999 through December 2007...
March 2009: Hepato-gastroenterology
Saulius Grizas, Antanas Gulbinas, Giedrius Barauskas, Juozas Pundzius
The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is controversial. Therefore, a randomized clinical trial with attempts to address the question of plenitude of routine application of postoperative enteral feeding on rate of postoperative complications following pancreatoduodenectomy was performed. Sixty patients undergoing pancreatoduodenectomy were blindly randomized into two groups: 30 patients in the first group received early enteral nutrition (EEN), while 30 patients in the second group were given early natural nutrition (ENN)...
2008: Medicina
Takehiro Okabayashi, Michiya Kobayashi, Isao Nishimori, Takeki Sugimoto, Saburo Onishi, Kazuhiro Hanazaki
BACKGROUND/PURPOSE: Although the operative mortality and morbidity associated with pancreatoduodenectomy (PD) has been decreasing, pancreatic fistula remains a potentially fatal complication. The aim of this study was to identify risk factors and predictors of pancreatic fistula formation, and ways to prevent this in a consecutive series of PD patients in a single institution. METHODS: The association between pancreatic fistula formation and various clinical parameters was investigated in 50 patients who underwent PD at Kochi Medical School from January 1991 through February 2006...
2007: Journal of Hepato-biliary-pancreatic Surgery
Nada Rayes, Daniel Seehofer, Tom Theruvath, Martina Mogl, Jan M Langrehr, Natascha C Nüssler, Stig Bengmark, Peter Neuhaus
OBJECTIVE: Patients undergoing pancreas resection carry several risk factors for nosocomial bacterial infections. Pre- and probiotics (synbiotics) are potentially useful for prevention of these infections. SUMMARY BACKGROUND DATA: First trials in patients following major abdominal surgery including liver transplantation using one Lactobacillus (LAB) and one fiber showed significant reduction of infection rates and reduced length of antibiotic therapy compared with a control group...
July 2007: Annals of Surgery
Judit Hallay, Csaba Micskei, Béla Fülesdi, Gábor Kovács, Zsolt Szentkereszty, István Takács, Péter Arkosy, Sándor Sipka, Péter Sápy
UNLABELLED: Patients operated on for pancreas head cancer were investigated postoperatively. Fifteen patients (Group I) were treated with FREKA TRELUMINA tube (they benefited of safe gastric emptying and jejunal feeding), 5 patients (Group II) did not receive this treatment. Laboratory results were measured preoperatively, on the first, 4th and 10th days. Bowel movements were monitored. All patients were received Total Parenteral Nutrition--25 kcal/kg/day. Group I received on the first postoperative day 500 ml tea, from the second day we gradually increased the oral intake to a maximum of 1500 mls...
December 2005: Magyar Sebészet
J M Watters, S M Kirkpatrick, S B Norris, F M Shamji, G A Wells
OBJECTIVE: The authors set out to determine whether immediate enteral feeding minimizes early postoperative decreases in handgrip and respiratory muscle strength. SUMMARY BACKGROUND DATA: Muscle strength decreases considerably after major surgical procedures. Enteral feeding has been shown to restore strength rapidly in other clinical settings. METHODS: A randomized, controlled, nonblinded clinical trial was conducted in patients undergoing esophagectomy or pancreatoduodenectomy who received immediate postoperative enteral feeding via jejunostomy (fed, n = 13), or no enteral feeding during the first 6 postoperative days (unfed, n = 15)...
September 1997: Annals of Surgery
T H Cogbill, E E Moore, J L Kashuk
Forty-four patients were operated on for pancreatic trauma during the past three years. Twenty-one patients (48%) were treated by drainage alone, nine (21%) by distal resection, eight (19%) by duodenal diversion, and one (2%) by pancreatoduodenectomy. Active sump drainage was used in 27 patients (71%) and early enteral feeding by needle catheter jejunostomy in 24 (63%) postoperatively. Of the 38 patients who survived the initial operation, two (5%) died postoperatively. Pancreas-related complications occurred in 13 patients (34%)...
May 1982: Archives of Surgery
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