BACKGROUND

Enhanced recovery after surgery (ERAS) protocols following pancreaticoduodenectomy (PD) have shown promising results. In all previous studies on ERAS following PD; the earliest oral feeding (liquids only) was started on the first postoperative day; our objective was to start oral (liquid and soft) feed at 6 hours of surgery and assess its effect on postoperative outcome.

MATERIALS AND METHODS

All 26 patients (Group-I) undergoing PD from November 2021 to June 2022 were prospectively enrolled and subjected to early oral feeding (EOF), i.e., oral feed at 6 hours. They were compared with a retrospective cohort (Group-II) of 40 patients who received conventional oral feeding (COF) i.e., by feeding jejunostomy on day 1.

RESULTS

Age, intraoperative blood loss, and operative time were comparable. Time to start oral liquid (0 vs 1.5 ± 1.2 days, = 0.00), soft diet (0 vs 3.8 ± 1.9 days, = 0.00) and solid diet (3.1 ± 0.5 vs 7.2 ± 2.9 days, = 0.00) was significantly shorter in EOF group. Nasogastric (NG) tube removal was earlier (1.6 ± 1.5 vs 3.9 ± 1.7 days, 0.00) and required reinsertion less frequently in the EOF group. First stool passage time (3.7 ± 0.9 vs 5.9 ± 1.8 days, 0.00) and stoppage of intravenous fluids (3.4 ± 0.8 vs 5.2 ± 1.8 days, 0.00) were significantly earlier in EOF group. The length of postoperative hospital stay was less (5.9 ± 2.6 vs 8.8 ± 4.1 days, 0.007) in the EOF group. There was no significant difference in postoperative complications, 90-day mortality, and readmission rates between the two groups.

CONCLUSION

Early oral feeding after PD is feasible, safe, and reduces hospital stay.

HOW TO CITE THIS ARTICLE

Sharma A, Mahla VK, Nagar A, Early vs Conventional Oral Feeding after Pancreaticoduodenectomy: A Prospective Observational Study. Euroasian J Hepato-Gastroenterol 2025;15(1):29-33.