Martignoni M E, Friess H, Sell F, Ricken L, Shrikhande S, Kulli C, Büchler M W
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, Bern, Switzerland.
Am J Surg. 2000 Jul;180(1):18-23. doi: 10.1016/s0002-9610(00)00418-9.
Delayed gastric emptying is one of the most frequent postoperative complications after Whipple resection. In the present study we evaluated the role of enteral nutrition in the development of delayed gastric emptying after Whipple resection.
Between January 1996 and June 1998, 64 patients (30 female, 34 male) underwent a classic (n = 27) or pylorus-preserving (n = 37) Whipple resection. Two patients were excluded; 30 patients received enteral and 32 patients received no-enteral nutrition.
Delayed gastric emptying occurred significantly more in patients with enteral (17 of 30, 57%) than in patients with no-enteral nutrition (5 of 32, 16%) (P <0.01). Consequently, patients in the enteral nutrition group had a nasogastric tube for a significantly (P<0.01) longer period and had a significantly (P<0.01) longer hospital stay than patients in the no-enteral nutrition group. There were no differences in the frequency of occurrence of other postoperative complications between patients with enteral and no-enteral nutrition.
In patients undergoing a Whipple resection, enteral nutrition is associated with a higher frequency of delayed gastric emptying with no advantages regarding other postoperative complications and should therefore be restricted to specific indications.
胃排空延迟是胰十二指肠切除术后最常见的术后并发症之一。在本研究中，我们评估了肠内营养在胰十二指肠切除术后胃排空延迟发生中的作用。
1996年1月至1998年6月期间，64例患者（30例女性，34例男性）接受了经典（n = 27）或保留幽门（n = 37）的胰十二指肠切除术。两名患者被排除；30例患者接受肠内营养，32例患者未接受肠内营养。
接受肠内营养的患者发生胃排空延迟的比例（30例中的17例，57%）显著高于未接受肠内营养的患者（32例中的5例，16%）（P <0.01）。因此，肠内营养组患者留置鼻胃管的时间显著更长（P<0.01），住院时间也显著更长（P<0.01）。接受肠内营养和未接受肠内营养的患者在其他术后并发症的发生频率上没有差异。
在接受胰十二指肠切除术的患者中，肠内营养与胃排空延迟的发生率较高相关，在其他术后并发症方面没有优势，因此应仅限于特定适应症使用。
