title: Effect of early enteral tube feeding on patient outcome following pancreaticoduodenectomy.
abstract: OBJECTIVE
  Morbidity after pancreaticoduodenectomy (PD) is nearly 50%. In this study we analyzed if early enteral nutrition via feeding tube (FT) contributes to better patient outcomes.
  
  
  METHODS
  Patients undergoing PD from 2003-2010. FTs were placed routinely before August 2006, and omitted thereafter. Short-term outcome measures included: time to start of oral diet, need for total parenteral nutrition (TPN), morbidity and mortality, pancreatic fistula, complications from FT, hospital length of stay, and disposition. Long-term outcome measures included time to start adjuvant therapy, and survival.
  
  
  RESULTS
  N = 59 (25 had FT, 34 did not). Adenocarcinoma was found in 88%. Early institution of tube feeding had no positive impact on any of the outcome measures. There were three FT-related complications.
  
  
  CONCLUSIONS
  Our results demonstrate that FT placement does not improve short-term or long-term outcomes after PD. Moreover, major complications can result from FT placement. We do not advocate the routine use of FT after PD.
authors.affiliation: University of Connecticut Medical School, Farmington, USA.
authors.forename: Georgios V
authors.initials: GV
authors.lastname: Georgakis
authors.forename: David P
authors.initials: DP
authors.lastname: Eisenberg
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Piorkowski
authors.forename: William P
authors.initials: WP
authors.lastname: Macaulay
authors.forename: Ramon E
authors.initials: RE
authors.lastname: Jimenez
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004379:Duodenal Neoplasms / Q000601:surgery*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome