title: Clinical feasibility and nutritional effects of early oral feeding after pancreaticoduodenectomy.
abstract: OBJECTIVE
  Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD.
  
  
  METHODS
  Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group). Postoperative complications, energy intake, and length of stay (LOS) were reviewed.
  
  
  RESULTS
  Demographic factors were similar in the two groups. The EOF group had a significantly shorter LOS (25.9±8.5 days vs. 32.3±16.3 days; p=0.01) than the TOF group. The rates of anastomotic leak (1.2% vs. 16%, p=0.00) and reoperation (3.7% vs. 20%, p=0.01) were significantly lower in the EOF group. In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group.
  
  
  CONCLUSIONS
  Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.
authors.affiliation: Department of Surgery, Daejeon Sun Hospital, Daejeon, Korea.
authors.forename: Si Eun
authors.initials: SE
authors.lastname: Hwang
authors.affiliation: Department of Nutrition Service, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Jung
authors.affiliation: Department of Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, and Research Institute of Clinical Medicine, Jeonju, Korea.
authors.forename: Baik Hwan
authors.initials: BH
authors.lastname: Cho
authors.affiliation: Department of Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, and Research Institute of Clinical Medicine, Jeonju, Korea.
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yu
keywords: Complication; Early oral feeding; Length of stay; Pancreaticoduodenectomy