Endoscopic nasojejunal feeding tube placement in patients with severe hepatopancreatobiliary diseases: a retrospective study of 184 patients.
BACKGROUND
Total parenteral nutrition (TPN) has been recognized as the mainstay of nutritional support in patients with severe hepatopancreatobiliary (HPB) diseases for decades. However, recent studies advocate the utilization of endoscopic nasojejunal feeding tube placement (ENFTP), rather than the conventional approach. This study was designed to compare the clinical value of ENFTP and TPN in patients with severe HPB diseases.


METHODS
Two groups of patients with severe HPB diseases were analyzed retrospectively. One group of 88 patients received ENFTP, and the other 96 received TPN. Routine blood levels, serum glucose and prealbumin, hepatic and renal function, serum lipid, and calcium were measured at baseline and after 1, 2, and 4 weeks of nutritional support. Also, complication rate, mortality, nutritional support time, mechanical ventilation time, mean length of time in intensive care unit, and duration of hospital stay were analyzed.


RESULTS
After 4 weeks of nutritional support, the degree of recovery of red blood cells, prealbumin, and blood glucose was greater in the ENFTP than in the TPN group (P<0.05). Furthermore, the ENFTP group showed a lower incidence of septicemia, multiple organ dysfunction syndrome, peri-pancreatic infection, biliary infection, and nosocomial infection, in addition to shorter nutritional support time and hospital stay (P<0.05).


CONCLUSIONS
ENFTP is much more effective than TPN in assisting patients with severe HPB diseases to recover from anemia, low prealbumin level, and high serum glucose, as well as in decreasing the rates of various infections (pulmonary infection excluded), multiple organ dysfunction syndrome rate, nutrition support time, and length of hospital stay. Therefore, ENFTP is safer and more economical for clinical application.
Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. jifeng1126@sina.com
Feng
F
Ji
Jing-Li
JL
Zhao
Xi
X
Jin
Chun-Hua
CH
Jiao
Yu-Yao
YY
Hu
Qin-Wei
QW
Xu
Wei-Xing
WX
Chen
D000328:Adult; D000368:Aged; D000740:Anemia / Q000517:prevention & control; D001660:Biliary Tract Diseases / Q000628:therapy*; D016145:Endoscopy, Digestive System; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D034141:Hypoalbuminemia / Q000517:prevention & control; D007902:Length of Stay; D008107:Liver Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000517:prevention & control; D009752:Nutritional Status; D010182:Pancreatic Diseases / Q000628:therapy*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies