title: Enteral Nutrition Support Reduces the Necessity of Total Parenteral Nutrition to Reach Patient-Specific Caloric Goals Postpancreaticoduodenectomy.
abstract: OBJECTIVE
  Pancreaticoduodenectomy (PD) is associated with significant rates of postoperative complications. Although there is evidence that enteral nutrition support (ENS) may reduce postoperative sepsis, the true value of ENS in the abrogation of septic complications remains controversial. The aim of our study is to investigate the postoperative outcome of patients post-PD with and without ENS.
  
  
  METHODS
  Using our prospective institutional database, we identified 202 patients from 2001 through 2009 who underwent PD. Of the 202 patients, 121 matched our inclusion criteria. In total, 67 of 121 (55.4%) patients received ENS, whereas 54 (44.6%) patients had no ENS and served as controls. Postoperative morbidity and mortality were recorded and analyzed.
  
  
  RESULTS
  No significant differences were found in the postoperative morbidity of the patients. The anastomotic leak rate was 13% in both the ENS and control groups (P = 0.846). There was no difference in mortality within the two groups (4% vs 5%, P = 0.881). Significantly more patients in the control group received total parenteral nutrition (P = 0.033).
  
  
  CONCLUSIONS
  ENS is not associated with lower rates of postoperative morbidity and mortality. It does, however, reduce the necessity of additional total parenteral nutrition to reach patient-specific caloric goals.
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Mario H
authors.initials: MH
authors.lastname: Mueller
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katherine
authors.initials: K
authors.lastname: Vandenbussche
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Pelliccia
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Myles
authors.initials: M
authors.lastname: Smith
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Karanicolas
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Sherif
authors.initials: S
authors.lastname: Hanna
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Natalie
authors.initials: N
authors.lastname: Coburn
authors.affiliation: From the Sunnybrook Health Sciences Centre, University of Toronto, Canada, the Royal Marsden National Health Service Foundation Trust, London, United Kingdom, and the Department of Surgery, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Calvin
authors.initials: C
authors.lastname: Law
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D016022:Case-Control Studies; D004067:Digestive System Neoplasms / Q000601:surgery*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D020127:Recovery of Function