Enteral nutrition prolongs delayed gastric emptying in patients after Whipple resection.
BACKGROUND
Delayed gastric emptying is one of the most frequent postoperative complications after Whipple resection. In the present study we evaluated the role of enteral nutrition in the development of delayed gastric emptying after Whipple resection.


METHODS
Between January 1996 and June 1998, 64 patients (30 female, 34 male) underwent a classic (n = 27) or pylorus-preserving (n = 37) Whipple resection. Two patients were excluded; 30 patients received enteral and 32 patients received no-enteral nutrition.


RESULTS
Delayed gastric emptying occurred significantly more in patients with enteral (17 of 30, 57%) than in patients with no-enteral nutrition (5 of 32, 16%) (P <0.01). Consequently, patients in the enteral nutrition group had a nasogastric tube for a significantly (P<0.01) longer period and had a significantly (P<0.01) longer hospital stay than patients in the no-enteral nutrition group. There were no differences in the frequency of occurrence of other postoperative complications between patients with enteral and no-enteral nutrition.


CONCLUSIONS
In patients undergoing a Whipple resection, enteral nutrition is associated with a higher frequency of delayed gastric emptying with no advantages regarding other postoperative complications and should therefore be restricted to specific indications.
Martignoni
M E
ME
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, Bern, Switzerland.
Friess
H
H
Sell
F
F
Ricken
L
L
Shrikhande
S
S
Kulli
C
C
Büchler
M W
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001650:Bile Duct Neoplasms / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation; D007583:Jejunum / Q000601:surgery; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods; D011183:Postoperative Complications; D011708:Pylorus / Q000601:surgery; D018709:Statistics, Nonparametric; D013997:Time Factors