Use of three lumen catheter facilitates bowel movement after pancreato-duodenectomy.
OBJECTIVE
The advantages of jejunal nutrition in postoperative bowel paralysis following pancreato-duodenectomy were analyzed.


METHODS
Patients resected for pancreatic cancer received 25 kcal/kg/day and were followed up for 10 days postoperatively. Nasojejunal tube ensured enteral feeding in 16 patients (Gr. I), 6 patients (Gr. II) were nourished parenterally. Laboratory parameters, outcome were compared. Bowel movements were registered. Patients of Gr.1 received 25 kcal/kg parenterally. Jejunal nutriment (1.5 cal/mL) followed gradually up to 1500mL. Parenteral nutriment decreased reflecting enteral intake. Patients of Gr. II were nourished parenterally only for 8 days. Laboratory data were measured preoperatively, on the 1st, 4th, 10th days.


RESULTS
The first stool appeared on the 4th day in Gr. I In Gr. II the bowel movement was delayed by 8 days. Laboratory data from the 1st, and 10th days were compared. In Gr. I serum total protein increased from 48.06 to 58.7g/L (p<0.001), serum albumin from 27.5 to 32.2g/L (p<0.02), CRP decreased from 117.8 to 74.1mg/L (p<0.035). No changes were significant in Gr. II. Length of hospitalization, weight loss did not differ between the 2 groups.


CONCLUSIONS
Immediately postoperative use of a three-luminal tube ensured early enteral nutrition, improved serum total protein, albumin values and facilitated bowel movements.
Hallay
Judit
J
Department of Anesthesiology & Intensive Care, University of Debrecen, Medical & Health Science Cente,r Debrecen, Hungary. jhallay@dote.hu
Micskei
Cs
C
Fülesdi
B
B
Kovács
G
G
Szentkereszty
Zs
Z
Takács
I
I
Sipka
S
S
Bodolay
E
E
Sápy
P
P
D001798:Blood Proteins / Q000378:metabolism; D002408:Catheters, Indwelling; D003112:Colonic Pseudo-Obstruction / Q000628:therapy*; D003672:Defecation; D004750:Enteral Nutrition / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation*; D015596:Nutrition Assessment; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism
D001798:Blood Proteins; D012709:Serum Albumin