Enteral Nutrition Is Superior To Total Parenteral Nutrition For Pancreatic Cancer Patients Who Underwent Pancreaticoduodenectomy

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. Results There was no significant difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN groups on the preoperative day, and the 1st,3rd postoperative days. However, on the 7th postoperative day, there was significant difference between the two groups in the serum levels of 24 h urinary nitrogen, total protein (TP), transferring (TF), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), y-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14th postoperative day, there was a significant difference between the two groups in the urinary levels of 24 h nitrogen, TP. TF. retinol binding protein. ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying in the EN and TPN groups was 0% and 20%. respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in the TPN group, respectively. Conclusions Compared to TPN, EN could improve the nutritional status, liver and kidney functions and blood glucose. It could also reduce the incidence of hemorrhage, delayed gastric emptying and pancreatic fistula. EN is better than TPN for pancreatic cancer patients who received pancreaticoduodenectomy.