title: Distal Enteral Feeding Helps Blood Sugar Control in Pancreatectomized Patients.
abstract: BACKGROUND
  The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more distal enteral anastomosis after PD may further improve glycemic status.
  
  
  METHODS
  To test the effect of distal enteral feeding on glucose metabolism in patients after PD, we performed a meal test on 20 patients via a nasogastric tube [proximal feeding group (PFG)] on post-operative day 5 and then via an intra-operatively placed jejunostomy feeding tube [distal feeding group (DFG)] on post-operative day. Blood samples were assessed for hormones and glucose.
  
  
  RESULTS
  The AUC0-120 min levels of GLP-1, C-peptide, and insulin after distal feeding were significantly higher than after proximal feeding. The AUC0-120 min levels of glucose in the DFG were significantly lower than in the PFG.
  
  
  CONCLUSIONS
  More distal enteral feeding contributed to better glucose metabolism after PD.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc. kptkptkpt@yahoo.com.tw.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wu
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc.
authors.forename: Ching-Yao
authors.initials: CY
authors.lastname: Yang
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc.
authors.forename: Ting-Chun
authors.initials: TC
authors.lastname: Kuo
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc.
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.affiliation: Department of Nursing, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Roc.
authors.forename: Pin-Yi
authors.initials: PY
authors.lastname: Chiang
authors.affiliation: Department of Nursing, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Roc.
authors.forename: Su-Hua
authors.initials: SH
authors.lastname: Hsieh
authors.affiliation: Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc. ywtien5106@ntu.edu.tw.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Tien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007441:Intubation, Gastrointestinal; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D019518:Postprandial Period / Q000502:physiology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D052216:Glucagon-Like Peptide 1