title: Is routine nasogastric tube insertion necessary in pancreaticoduodenectomy?
abstract: OBJECTIVE
  The necessity of nasogastric decompression after abdominal surgical procedures has been increasingly questioned for several years. Traditionally, nasogastric decompression is a mandatory procedure after classical pancreaticoduodenectomy (PD); however, we still do not know whether or not it is necessary for PD. The present study was designed to assess the clinical benefit of nasogastric decompression after PD.
  
  
  METHODS
  Between July 2004 and May 2007, 41 consecutive patients who underwent PD were enrolled in this study. Eighteen patients were enrolled in the nasogastric tube (NGT) group and 23 patients were enrolled in the no NGT group.
  
  
  RESULTS
  There were no differences in the demographics, pathology, co-morbid medical conditions, and pre-operative laboratory values between the two groups. In addition, the passage of flatus (P = 0.963) and starting time of oral intake (P = 0.951) were similar in both groups. In the NGT group, 61% of the patients complained of discomfort related to the NGT. Pleural effusions were frequent in the NGT group (P = 0.037); however, other post-operative complications, such as wound dehiscence and anastomotic leakage, occurred similarly in both groups. There was one case of NGT re-insertion in the NGT group.
  
  
  CONCLUSIONS
  Routine nasogastric decompression in patients undergoing PD is not mandatory because it has no clinical advantages and increases patient discomfort.
authors: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
authors: Yoon Young
authors: YY
authors: Choi
authors: Jungman
authors: J
authors: Kim
authors: Daekwan
authors: D
authors: Seo
authors: Dongho
authors: D
authors: Choi
authors: Min Joo
authors: MJ
authors: Kim
authors: Jung Hoon
authors: JH
authors: Kim
authors: Kyung-Jae
authors: KJ
authors: Lee
authors: Kyung Yul
authors: KY
authors: Hur