| Objective The study aims to use systematic review and meta-analysis to evaluate the effects of using enteral nutrition (EN) or total parenteral nutrition (TPN) in perioperative period of pancreaticoduodenectomy towards some clinical associated factors such as mortality rate, morbidity of postoperative complications and length of hospital stay of patients diagnosed as pancreatic cancers.Methods Use electronic databases such as PubMed and Cochrane and systemically retrieve all papers published between Jan1994and Dec2013which compare EN and TPN in perioperative period of pancreaticoduodenectomy and include appropriate papers after rigid selection. Use RevMan5.2.4software to analysis odds ratio (OR) and weighted mean difference (WMD). According to heterogeneity of the research, use fixed effects model or random effects model to do meta-analysis for the clinical associated factors such as mortality rate, morbidity of postoperative complications and length of hospital stay of patients. Results Five randomized controlled trials (RCT) carried out by different medical institutions including603patients who have had pancreaticoduodenectomy are included after retrieving relative database. Through analysis, there are no significant difference between TPN and EN in mortality rate (OR=2.80,95%CI0.39-12.52, P=0.37), morbidity of postoperative complications (OR=1.86,95%CI0.76-4.59, P=0.18), morbidity of pancreatic fistula (OR=1.38,95%CI0.74-2.58, P=0.32) and morbidity of gastric retention (OR=1.23,95%CI0.68-2.23, P=0.50). But there is significant difference between TPN and EN in length of hospital stay (WMD=1.46,95%CI0.88-2.05, P<0.00001).Conclusion Compared with RN, TPN doesn’t reduce the mortality rate and morbidity of postoperative complications in perioperative period of pancreaticoduodenectomy and it can’t reduce the morbidity of pancreatic fistula and gastric retention. However, EN can reduce the length of hospital stay compared with TPN. |
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