A Single-Center Clinical Study Of Different Enteral Nutrition Patterns After Pancreaticoduodenectomy

Research background and purpose:Pancreaticoduodenectomy(PD)has up to 30-50% postoperative complications due to the large range of surgical resection,involving the removal of many organs and complicated digestive tract reconstruction.In recent years,studies have found that malnutrition is an independent risk factor for the occurrence of related complications after PD.At present,the report is limited in choosing the best enteral nutrition route in the early stage after PD.This paper analyzes the patients after PD surgery,and aims to lay a foundation for the clinical selection of the safest and most efficient enteral nutrition route.Materials and Methods:This study collected the data of patients in the inpatient department of Deyang People’s Hospital from February 2022 to February 2023.The patients were random number table,odd number was nasal intestinal tube group,set as experimental group,even jejunostomy group,and the control group according to the inclusion and exclusion criteria.All patients underwent open pancreaticoduodenectomy,and 22 patients were finally included.Through postoperative laboratory examination,bile leakage,pancreatic leakage,bleeding,gastric emptying delay,postoperative hospital length,postoperative duration,and postoperative bleeding amount.Result:1、The study found that both groups had pancreatic fistula(experimental group 69.2% VS control group 66.7%,P = 0.899),biliary fistula(23.1% VS in experimental group 0.00% in control group,P =0.121),abdominal infection(69.2% VS 66.7% control group,P = 0.899),gastric emptying disorder(38.5% VS 33.3% control group,P = 0.806),gastrointestinal bleeding(30.8% VS 11.1% in the control group,P = 0.279),abdominal hemorrhage(7.7% VS 0.00% in control group,P = 0.394)and no significant difference in postoperative complications.2、Patients in both groups had nausea and vomiting(76.2% 77.8%,p=0.138),abdominal distension(66.7%,p = 0.806),diarrhea(7.70% VS33.3%,p=0.125),and glucose metabolism(30.8% VS 33.3%,p=0.899).There were also no significant differences in catheter-related complications such as nutrient tube shedding(0.00% VS control 11.1%,p=0.219),nutrient tube blockage(0.00% VS control 11.1%,p=0.219),and nutrient tube displacement(0.00% VS control 11.1%,p=0.219).3、There was no difference in postoperative hospitalization length(p=0.414)and intraoperative blood volume(p=0.588),but the time was significantly different(p <0.001)and the upper nasotube group and the jejunostomy group(p=0.004).Conclusion:The mean surgical duration of the jejunostomy group was significantly longer than that of the nasenteral group(p <0.05),but there was no significant difference in the prevention of postoperative complications and catheter-related complications(p> 0.05).Nasoenteral tube is more suitable for early enteral nutrition in patients after pancreaticoduodenectomy.