Hospital Management Institute, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
HPB (Oxford). 2020 Jan;22(1):20-25. doi: 10.1016/j.hpb.2019.06.002. Epub 2019 Jul 25.
An appropriate nutritional support is an important consideration for patients undergoing pancreaticoduodenectomy (PD). Recently, early enteral nutrition (EEN) has been considered to be more effective than total parenteral nutrition (TPN) for the early recovery of patients after many digestive tract surgeries. However, there is little evidence to support EEN in patients undergoing PD.
A systematic literature review was performed to identify relevant studies before December 2018. Statistical analysis was carried out using Review Manager 5.3.
Nine studies with 1258 patients were included in the meta-analysis. Six studies compared EEN and TPN and three compared two strategies combined vs. a single strategy. The length of hospital stay (LOS) in the EEN group was significantly shorter than that in the TPN group (P < 0.001). There was no difference in the risk of postoperative complications, infections, and mortality between the EEN and TPN groups. In the comparison of two combined strategies vs. one, no significant difference was seen in overall postoperative complications, LOS, or mortality.
Compared with TPN, EEN is a safe strategy and can substantially shorten the LOS of patients.
对于接受胰十二指肠切除术（PD）的患者，适当的营养支持是一个重要的考虑因素。最近，许多消化道手术后，早期肠内营养（EEN）被认为比全肠外营养（TPN）更能促进患者的早期康复。然而，目前几乎没有证据支持 PD 患者使用 EEN。
我们进行了系统的文献综述，以确定截至 2018 年 12 月的相关研究。使用 Review Manager 5.3 进行统计分析。
纳入了 9 项研究，共 1258 名患者，进行了荟萃分析。其中 6 项研究比较了 EEN 和 TPN，3 项研究比较了两种联合策略与单一策略。EEN 组的住院时间（LOS）明显短于 TPN 组（P<0.001）。EEN 和 TPN 组之间在术后并发症、感染和死亡率方面没有差异。在两种联合策略与一种策略的比较中，在总体术后并发症、LOS 或死亡率方面没有显著差异。
与 TPN 相比，EEN 是一种安全的策略，可以显著缩短患者的 LOS。
