Effect of early enteral nutrition combined with parenteral nutrition on patients after pancreaticoduodenectomy

Abstract

Objective To investigate the effect of early enteral nutrition combined with parenteral nutrition on patients received pancreaticoduodenectomy. Methods A retrospective analysis of 222 patients who underwent pancreaticoduodenectomy at Nanjing Drum Tower Hospital from January 2012 to November 2018 was conducted. According to different feeding methods, patients were divided into two groups: early enteral nutrition combined with parenteral nutrition group (EEN+PN group, n=141) and total parenteral nutrition group (TPN group, n=81). The nutritional indicator, liver function at 1 day before operation and 6 days after operation, postoperative complications and hospital stay were compared between the two groups. Results Compared with TPN group, the decrease difference of prealbumin (PAB) in EEN+PN group was statistically significant (P<0.05). Total bilirubin (TB) and direct bilirubin (DB) in EEN+PN group decreased significantly on the 6th day after operation (P<0.01). The hospital stay in EEN+PN group was significantly shortened (P<0.05). The infection complications in EEN+PN group were less than those in TPN group (41.8% vs65.4%, P<0.05). The delayed gastric emptying rate and hyperglycemia rate in EEN+PN group were lower than those in TPN group (P<0.05).Conclusion Early enteral nutrition combined with parenteral nutrition can significantly improve the liver function of patients after operation, reduce infection and delayed gastric emptying, and shorten the postoperative hospital stay.

Keywords

• pancreaticoduodenectomy
• enteral nutrition
• parenteral nutrition
• complication
• prealbumin
• total bilirubin
• direct bilirubin
• delayed gastric emptying