Enteral nutrition in pancreaticoduodenectomy: a literature review.
Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%-40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN) and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH), length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications.
School of Oncology and Experimental Surgery, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. buscemi.salvatore@gmail.com.|Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. buscemi.salvatore@gmail.com.
Salvatore
S
Buscemi
Giaccone", University Hospital, School of Medicine, School of Biotechnology, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.
Giuseppe
G
Damiano
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.|Giaccone", University Hospital, School of Medicine, School of Biotechnology, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.|School of Surgical Biotechnology and Regenerative Medicine in Organ Failure, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.
Vincenzo D
VD
Palumbo
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. gabriele.spinelli@unipa.it.
Gabriele
G
Spinelli
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. silvia.ficarella@gmail.com.
Silvia
S
Ficarella
School of Biotechnology, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giulialom@virgilio.it.
Giulia
G
Lo Monte
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. attilioignazio.lomonte@unipa.it.
Antonio
A
Marrazzo
Department of Surgical, Oncological and Dentistry Studies, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.|Giaccone", University Hospital, School of Medicine, School of Biotechnology, University of Palermo, via Del Vespro 129, 90127 Palermo, Italy. giuse.damiano@gmail.com.
Attilio I
AI
Lo Monte
D004750:Enteral Nutrition / Q000009:adverse effects*; D018589:Gastroparesis / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D015201:Meta-Analysis as Topic; D010185:Pancreatic Fistula / Q000209:etiology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome