title: Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy.
abstract: OBJECTIVE
  To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy.
  
  
  METHODS
  From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical and clinical parameters were recorded and analyzed between the two groups.
  
  
  RESULTS
  There was no significant difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN groups on the preoperative day, the 1st and 3 rd postoperative days. However, on the 7th postoperative day, there was significant difference between the two groups in 24 h urinary nitrogen, serum levels of, total protein (TP), transferrin (TF), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14th postoperative day, there was a significant difference between the two groups in terms of urinary levels of 24 h nitrogen, TP, TF, retinol binding protein, ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying in the EN and TPN groups was 0% and 20%, respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in the TPN group, respectively.
  
  
  CONCLUSIONS
  EN is better than TPN for pancreatic cancer patients who received pancreaticoduodenectomy.
authors.affiliation: The Third Centeral Hospital, Hedong District, Tianjin, China 300170.
authors.forename: Changli
authors.initials: C
authors.lastname: Liu
authors.forename: Zhi
authors.initials: Z
authors.lastname: Du
authors.forename: Cheng
authors.initials: C
authors.lastname: Lou
authors.forename: Chenxuan
authors.initials: C
authors.lastname: Wu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yuan
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Guiming
authors.initials: G
authors.lastname: Shu
authors.forename: Yijun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001798:Blood Proteins / Q000378:metabolism; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood / Q000652:urine; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005746:Gastric Emptying; D005947:Glucose / Q000378:metabolism; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000652:urine; D010185:Pancreatic Fistula / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010289:Parenteral Nutrition, Total / Q000379:methods*; D011183:Postoperative Complications; D014168:Transferrin / Q000378:metabolism; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D014168:Transferrin; D003404:Creatinine; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D005947:Glucose; D009584:Nitrogen; D001663:Bilirubin