Gastric Decompression and Enteral Feeding Through a Double-Lumen Gastrojejunostomy Tube Improves Outcomes After Pancreaticoduodenectomy

Abstract

In patients undergoing PD, insertion of a GJT is safe. Moreover, insertion of a GJT improves average length of stay. At the time of resection of periampullary tumors, GJT insertion should be considered, especially given this is a patient population in which weight loss and cachexia are frequent.

Safety of total gastrectomy without nasogastric and nutritional intubation

“…The incidence of pulmonary complications, wound infection and anastomotic leakage was also not significantly different in colorectal surgery without intubation (22). In accordance with these previous findings, we observed that gastric and nutritional intubation prolonged operative time, increased the incidence of fever, and increased the rate of total complications according to the logistic regression analysis.…”

Enteral Nutrition and Biliopancreatic Diversion Effectively Minimize Impacts of Gastroparesis After Pancreaticoduodenectomy

“…[9][10][11][12] To minimize the adverse impacts of gastric stasis after PD, we planned to resume enteral feeding via an intraoperatively placed jejunal feeding tube. However, enteral feeding stimulates secretion of gut hormones and in turn secretion of biliary, pancreatic, and gastrointestinal juices.…”

Enteral versus Parenteral Nutrition after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in the English Literature

“…11 From this point of view, many recent clinical studies, 12-14 reviews, 15,16 meta-analyses, [17][18][19][20][21][22][23] and guidelines [24][25][26] strongly recommended the use of EN compared with PN in the critically ill and surgical patients because of a lower infection rate or shorter duration of hospital stay with accompanying cost savings. Some randomized controlled trials (RCTs), [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] on the other hand, failed to demonstrate that there was statistical benefit to EN. The mechanisms explaining this benefit of EN over PN remain unknown.…”