Buscemi Salvatore, Damiano Giuseppe, Palumbo Vincenzo D, Spinelli Gabriele, Ficarella Silvia, Lo Monte Giulia, Marrazzo Antonio, Lo Monte Attilio I
School of Oncology and Experimental Surgery, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy.
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy.
Nutrients. 2015 Apr 30;7(5):3154-65. doi: 10.3390/nu7053154.
Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%-40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN) and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH), length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications.
胰十二指肠切除术(PD)被认为是壶腹周围癌的金标准治疗方法。该手术的发病率为30%-40%。接受胰十二指肠切除术的患者常出现围手术期营养不良,术后早期情况更糟,会影响愈合过程、肠屏障功能及术后并发症的数量。很少有研究关注肠内营养(EN)与术后并发症之间的关系。我们的目的是进行一项综述,仅纳入随机对照试验的荟萃分析或设计良好的研究,以获取关于胰十二指肠切除术后EN与主要并发症及结局(如胃排空延迟(DGE)、术后胰瘘(POPF)、胰十二指肠切除术后出血(PPH)、住院时间和感染性并发症)之间相关性的证据。多项研究,尤其是随机对照试验表明,EN不会增加DGE的发生率。EN对PD术后患者似乎是安全且可耐受的,即使在POPF、PPH、住院时间和感染性并发症方面未显示出任何优势。