Comparison of enteral nutrition with combined enteral and parenteral nutrition in post-pancreaticoduodenectomy patients: a pilot study

Nagata, Shigeyuki; Fukuzawa, Kengo; Iwashita, Yukio; Kabashima, Akira; Kinoshita, Tadahiko; Wakasugi, Kenzo; Maehara, Yoshihiko

doi:10.1186/1475-2891-8-24

Cited by 32 publications

(25 citation statements)

References 15 publications

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“…A total of 51 articles were utilized for the review, with 14 addressing malnutrition and pancreatic dysfunction at pancreatic cancer diagnosis [13,14,15,16,17,18,19,20,21,22,23,24,25,26]; 19 addressing pancreatic dysfunction after surgery [27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45], including 10 which also discussed preoperative dysfunction and nutrition [27,30,31,32,33,35,37,39,40,41]; and 18 addressing nutritional intervention [11,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62] (Figure 1). …”

Section: Resultsmentioning

confidence: 99%

“…Clinicians have also tried a dual EN + TPN strategy to optimize postoperative nutritional status. Nagata et al reported that patients who received EN with TPN, had a significantly higher rate of duration and discontinuance of enteral feeding, compared to those who just received EN [50]. There were no differences in postoperative morbidity, catheter-related infections, percent of weight loss, and postoperative length of stay.…”

Section: Discussionmentioning

confidence: 99%

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Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection

et al. 2017

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Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions. Nutritional and metabolic dysfunctions in patients with pancreatic cancer lack characterization, and few guidelines exist for nutritional support in patients after surgical resection. We reviewed publications from the past two decades (1995–2016) addressing the nutritional and metabolic status of patients with pancreatic cancer, grouping them into status at the time of diagnosis, status at the time of resection, and status of nutritional support throughout the diagnosis and treatment of pancreatic cancer. Here, we summarize the results of these investigations and evaluate the effectiveness of various types of nutritional support in patients after pancreatectomy for pancreatic adenocarcinoma (PDAC). We outline the following conservative perioperative strategies to optimize patient outcomes and guide the care of these patients: (1) patients with albumin < 2.5 mg/dL or weight loss > 10% should postpone surgery and begin aggressive nutrition supplementation; (2) patients with albumin < 3 mg/dL or weight loss between 5% and 10% should have nutrition supplementation prior to surgery; (3) enteral nutrition (EN) should be preferred as a nutritional intervention over total parenteral nutrition (TPN) postoperatively; and, (4) a multidisciplinary approach should be used to allow for early detection of symptoms of endocrine and exocrine pancreatic insufficiency alongside implementation of appropriate treatment to improve the patient’s quality of life.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection

et al. 2017

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“…In fact, most clinical studies have not been able to demonstrate the effectiveness of EN in the clinical course of these patients [9][10][11][12][13][14][15]. Shen et al reported that EN appeared safe and tolerable for patients after pancreatoduodenectomy, but they did not show advantages in terms of infectious complications and postoperative hospital stay by accumulation of data from recent RCTs [16].…”

Section: Discussionmentioning

confidence: 99%

The Role of Nutritional Management in the Clinical Course of Severe Complications Associated with the Pancreas after Abdominal Surgery: Presentation of Four Cases

Yukitoshi¹,

Mishima²,

Azuma³

et al. 2014

JACCOA

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Background: All surgeons should note that complications associated with the pancreas after abdominal surgery can be severe and can induce life-threatening problems such as sepsis, abdominal abscess, and intra-abdominal hemorrhage. In such situations, nutritional management is a key element of therapy to achieve a favorable clinical course. Methods:We reviewed the clinical course of four patients with complications associated with the pancreas after abdominal surgery from

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“…However, postoperative total enteral feeding is associated with complications such as diarrhea, abdominal distention and abdominal cramps. These symptoms worsened with increasing caloric intake and finally lead to discontinuance of enteral feeding 4 . Also, gastroparesis is a frequent postoperative event following pancreatoduodenal resection, and this often necessitates prolonged gastric decompression and EN support 5 .…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Efficacy and Complications of Nasojejunal and Jejunostomy on Patients Undergoing Pancreaticoduodenectomy

Zhu

Qiu

et al. 2013

J Parenter Enteral Nutr

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Comparison of enteral nutrition with combined enteral and parenteral nutrition in post-pancreaticoduodenectomy patients: a pilot study

Cited by 32 publications

References 15 publications

Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection

Nutritional and Metabolic Derangements in Pancreatic Cancer and Pancreatic Resection

The Role of Nutritional Management in the Clinical Course of Severe Complications Associated with the Pancreas after Abdominal Surgery: Presentation of Four Cases

Comparative Analysis of the Efficacy and Complications of Nasojejunal and Jejunostomy on Patients Undergoing Pancreaticoduodenectomy

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