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enteral nutrition in postoperative pancreatic fistula

P Song, L Mao, X J Bian, T Zhou, Y Y Fan, J Zhang, M Xie, Y D Qiu
Objective: To investigate the clinical effect of bile reinfusion combined with enteral nutrition support before surgery for hilar cholangiocarcinoma. Methods: A retrospective analysis of patients with hilar cholangiocarcinoma who underwent surgical treatment at Nanjing Drum Tower Hospital Hepato-biliary-pancreatic Surgery Department from July 2010 to August 2017 was completed.A total of 52 cases were finally enrolled in our study.All the patients included, on the basis of whether they received preoperative drainage and bile reinfusion, were divided into non-drainage group( n =15) and drainage group( n =37)...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Märta Borghede, Lars Vinter-Jensen, Henrik H Rasmussen, Simon Veedfald, Jens F Rehfeld, Bolette Hartmann, Jens J Holst, Filip K Knop, David P Sonne
A serious complication to the laparoscopic Roux-en-Y gastric bypass (RYGB) is internal hernia, which can lead to massive bowel necrosis that may result in short bowel syndrome. We determined postprandial enteropancreatic hormonal responses and metabolites in a 22-year-old nondiabetic woman with a history of RYGB experiencing severe internal herniation with widespread bowel necrosis. Extensive resections were performed leaving her with a saliva fistula from the pouch-enteric anastomosis, an intact duodenum, 15 cm of jejunum, 35 cm of ileum, and intact colon...
May 2018: Physiological Reports
Laura Maggino, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Matthew T McMillan, Alex Borin, Bofeng Chen, Jeffrey A Drebin, Brett L Ecker, Douglas L Fraker, Major K Lee, Salvatore Paiella, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: The aim of this study was to describe characteristics and management approaches for grade B pancreatic fistula (B-POPF) and investigate whether it segregates into distinct subclasses. BACKGROUND: The 2016 ISGPS refined definition of B-POPF is predicated on various postoperative management approaches, ranging from prolonged drainage to interventional procedures, but the spectrum of clinical severity within this entity is yet undefined. METHODS: Pancreatectomies performed at 2 institutions from 2007 to 2016 were reviewed to identify B-POPFs and their treatment strategies...
January 12, 2018: Annals of Surgery
Julie Perinel, Christophe Mariette, Bertrand Dousset, Igor Sielezneff, Alain Gainant, Jean-Yves Mabrut, Sylvie Bin-Dorel, Michel El Bechwaty, Dominique Delaunay, Lorraine Bernard, Alain Sauvanet, Marc Pocard, Emmanuel Buc, Mustapha Adham
OBJECTIVES: The aim of this study was to compare nasojejunal early enteral nutrition (NJEEN) with total parenteral nutrition (TPN), after pancreaticoduodenectomy (PD), in terms of postoperative complications. BACKGROUND: Current nutritional guidelines recommend the use of enteral over parenteral nutrition in patients undergoing gastrointestinal surgery. However, the NJEEN remains controversial in patients undergoing PD. METHODS: Multicenter, randomized, controlled trial was conducted between 2011 and 2014...
November 2016: Annals of Surgery
Thilo Hackert, Markus Wolfgang Büchler
The management of acute necrotizing pancreatitis (ANP) has undergone a change of paradigms during the last 2 decades with a decreasing impact of surgical interventions. Modern ANP management is done conservatively as long as possible and therapeutic approaches aim at volume resuscitation, pain management and early enteral nutrition. The diagnostic gold standard of contrast-enhanced CT scan helps to evaluate the extent of necrosis of the pancreas, which correlates with the risk of tissue infection. The crucial point for decision making is the proven existence of infected pancreatic necrosis...
2016: Digestive Diseases
Yo-Ichi Yamashita, Tomoharu Yoshizumi, Kengo Fukuzawa, Takashi Nishizaki, Eiji Tsujita, Kiyoshi Kajiyama, Yuji Soejima, Motoyuki Yamagata, Kazuharu Yamamoto, Eisuke Adachi, Keishi Sugimachi, Yasuharu Ikeda, Hideaki Uchiyama, Takashi Maeda, Shinji Itoh, Norifumi Harimoto, Toru Ikegami, Yoshihiko Maehara
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduodenectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. PATIENTS AND METHODS: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified...
May 2016: Anticancer Research
Tsutomu Fujii, Suguru Yamada, Kenta Murotani, Yukiyasu Okamura, Kiyoshi Ishigure, Mitsuro Kanda, Shin Takeda, Satoshi Morita, Akimasa Nakao, Yasuhiro Kodera
The usefulness of enteral nutrition via a nasointestinal tube for patients who develop postoperative pancreatic fistula (POPF) after miscellaneous pancreatectomy procedures has been reported. However, no clear evidence regarding whether oral intake is beneficial or harmful during management of POPF after distal pancreatectomy (DP) is currently available.To investigate the effects of oral food intake on the healing process of POPF after DP.Multi-institutional randomized controlled trial in Nagoya University Hospital and 4 affiliated hospitals...
December 2015: Medicine (Baltimore)
Salvatore Buscemi, Giuseppe Damiano, Vincenzo D Palumbo, Gabriele Spinelli, Silvia Ficarella, Giulia Lo Monte, Antonio Marrazzo, Attilio I Lo Monte
Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%-40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN) and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH), length of stay and infectious complications...
April 30, 2015: Nutrients
Tsutomu Fujii, Akimasa Nakao, Kenta Murotani, Yukiyasu Okamura, Kiyoshi Ishigure, Tsuyoshi Hatsuno, Mitsuru Sakai, Suguru Yamada, Mitsuro Kanda, Hiroyuki Sugimoto, Shuji Nomoto, Shin Takeda, Satoshi Morita, Yasuhiro Kodera
BACKGROUND: The usefulness of enteral nutrition via a nasointestinal tube for patients who develop postoperative pancreatic fistula (POPF) after miscellaneous pancreatectomy procedures has been reported. However, no clear evidence regarding whether oral intake is possible during management of POPF after pancreatoduodenectomy (PD) is currently available. We investigated the effects of oral food intake on the healing process of POPF after PD by a multi-institutional randomized controlled trial...
November 2015: Annals of Surgical Oncology
Frédérique Maire, Philippe Ponsot, Clotilde Debove, Safi Dokmak, Philippe Ruszniewski, Alain Sauvanet
INTRODUCTION: Pancreatic fistula (PF) are frequent after pancreatic surgical resection, and particularly after enucleation. Endoscopic treatment might be proposed for postoperative PF, but has never been evaluated after pancreatic enucleation. PATIENTS AND METHODS: From January 2000 to June 2012, 161 patients underwent pancreatic enucleation in our center. In case of PF in the postoperative period, conservative management (somatostatin analogs combined with enteral or parenteral nutrition and drainage) was proposed...
November 2015: Surgical Endoscopy
Giuseppe Malleo, Alessandra Pulvirenti, Giovanni Marchegiani, Giovanni Butturini, Roberto Salvia, Claudio Bassi
BACKGROUND: Postoperative pancreatic fistula (POPF) is the leading complication after partial pancreatic resection and is associated with increased length of hospital stay and resource utilization. The introduction of a common definition in 2005 by the International Study Group of Pancreatic Surgery (ISGPS), which has been since employed in the vast majority of reports, has allowed a reliable comparison of surgical results. Despite the systematic investigation of risk factors and of surgical techniques, the incidence of POPF did not change in recent years, whereas the associated mortality has decreased...
October 2014: Langenbeck's Archives of Surgery
Xianghong Ye, Nanhai Peng, Fangzheng Jiang, Yuanhong Ni, Zhihui Tong, Weiqin Li, Jieshou Li
No abstract text is available yet for this article.
April 2013: American Surgeon
Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara, Masato Nagino
PURPOSES: External drainage of pancreatic juice using a pancreatic duct stent following pancreatoduodenectomy is widely performed. We hypothesized that the replacement of externally drained pancreatic juice would help to prevent postoperative complications, including pancreatic fistulas. METHODS: Sixty-four patients who underwent pancreatoduodenectomy between 2006 and 2008 were randomly assigned to either a pancreatic juice non-replacement (NR) or replacement (R) group...
February 2014: Surgery Today
Emilie Lermite, Daniele Sommacale, Tullio Piardi, Jean-Pierre Arnaud, Alain Sauvanet, Cornelis H C Dejong, Patrick Pessaux
BACKGROUND: Although mortality after pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) has decreased, morbidity still remains high. The aim of this review article is to present, define, predict, prevent, and manage the main complications after pancreatic resection (PR). METHODS: A non-systematic literature search on morbidity and mortality after PR was undertaken using the PubMed/MEDLINE and Embase databases. RESULTS: The main complications after PR are delayed gastric emptying (DGE), pancreatic fistula (PF), and bleeding, as defined by the International Study Group on Pancreatic Surgery...
June 2013: Clinics and Research in Hepatology and Gastroenterology
A Gerritsen, M G H Besselink, D J Gouma, E Steenhagen, I H M Borel Rinkes, I Q Molenaar
BACKGROUND: Current European guidelines recommend routine enteral feeding after pancreato-duodenectomy (PD), whereas American guidelines do not. The aim of this study was to determine the optimal feeding route after PD. METHODS: A systematic search was performed in PubMed, Embase and the Cochrane Library. Included were studies on feeding routes after PD that reported length of hospital stay (primary outcome). RESULTS: Of 442 articles screened, 15 studies with 3474 patients were included...
April 2013: British Journal of Surgery
Jin-ping Ma, Chuang-qi Chen, Shi-rong Cai, Han-ping Shi, Yu-long He, Wen-hua Zhan
OBJECTIVE: To compare the nutritional status between pancreaticojejuno-stomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy. METHODS: A retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy...
May 2012: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Michel Rayar, Laurent Sulpice, Bernard Meunier, Karim Boudjema
BACKGROUND: Delayed gastric emptying (DGE) is a common complication following pancreaticoduodenectomy (PD). Our retrospective study aimed to evaluate the influence of enteral nutrition (EN) on DGE incidence after standard PD with antrectomy and Child reconstruction. METHODS: We retrospectively analyzed 275 consecutive patients who underwent standard PD between January 2000 and September 2009. Patients operated on after January 2005 received EN (EN group, n = 152) until total oral alimentation...
May 2012: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Changli Liu, Zhi Du, Cheng Lou, Chenxuan Wu, Qiang Yuan, Jun Wang, Guiming Shu, Yijun Wang
OBJECTIVE: To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. METHODS: From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical and clinical parameters were recorded and analyzed between the two groups...
2011: Asia Pacific Journal of Clinical Nutrition
Stanislaw Klek, Marek Sierzega, Lukasz Turczynowski, Piotr Szybinski, Kinga Szczepanek, Jan Kulig
BACKGROUND & AIMS: Postoperative pancreatic fistula is the most common and potentially life-threatening complication after pancreatic surgery. Although nutritional support is a key component of conservative therapy in such cases, there have been no well-designed clinical trials substantiating the superiority of either total parenteral nutrition or enteral nutrition. This study was conducted to compare the efficacy and safety of both routes of nutritional intervention. METHODS: A randomized clinical trial was conducted in a tertiary surgical center of pancreatic and gastrointestinal surgery...
July 2011: Gastroenterology
Piotr Paluszkiewicz, Wojciech Dudek, Najib Daulatzai, Andrzej Stanislawek, Colin Hart
BACKGROUND: The tube decompression of the duodenum through an additional point of access of the duodenal wall or occasionally via the leak site decreases morbidity and mortality in patients with duodenal fistula. The objective of this paper is to present the detailed technique and clinical benefits of simplified duodenal and biliary decompression achieved by transampullary insertion of a T-tube with one-step duodenal closure for the prevention and/or treatment of duodenal leak. METHODS: The duodenocholangiostomy using T-tube with laterally perforated long duodenal limb was performed preventively in 4 patients and as a secondary procedure for septic duodenal leak in another selected 12...
April 2010: World Journal of Surgery
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