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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2015

01-11-2015 | Pancreatic Tumors

Influence of Food Intake on the Healing Process of Postoperative Pancreatic Fistula After Pancreatoduodenectomy: A Multi-institutional Randomized Controlled Trial

Authors: Tsutomu Fujii, MD, PhD, FACS, Akimasa Nakao, MD, PhD, FACS, Kenta Murotani, PhD, Yukiyasu Okamura, MD, PhD, Kiyoshi Ishigure, MD, PhD, Tsuyoshi Hatsuno, MD, PhD, Mitsuru Sakai, MD, PhD, Suguru Yamada, MD, PhD, FACS, Mitsuro Kanda, MD, PhD, Hiroyuki Sugimoto, MD, PhD, Shuji Nomoto, MD, PhD, Shin Takeda, MD, PhD, Satoshi Morita, PhD, Yasuhiro Kodera, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 12/2015

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Abstract

Background

The usefulness of enteral nutrition via a nasointestinal tube for patients who develop postoperative pancreatic fistula (POPF) after miscellaneous pancreatectomy procedures has been reported. However, no clear evidence regarding whether oral intake is possible during management of POPF after pancreatoduodenectomy (PD) is currently available. We investigated the effects of oral food intake on the healing process of POPF after PD by a multi-institutional randomized controlled trial.

Methods

Patients who developed POPF were randomly assigned to the dietary intake (DI) group (n = 30) or the fasted group [no dietary intake (NDI) group] (n = 29). The primary endpoint was the length of drain placement.

Results

No significant differences were found in the length of drain placement between the DI and NDI groups [27 (7–80) vs. 26 (7–70) days, respectively; p = .8858]. POPF progressed to a clinically relevant status (grade B/C) in 20 patients in the DI group and 19 patients in the NDI group (p = .9257). POPF-related intra-abdominal hemorrhage was found in 2 patients in the NDI group, but in no patients in the DI group (p = .1434). There were no significant differences in POPF-related intra-abdominal hemorrhage, the incidence of other complications, or the length of the postoperative hospital stay between the 2 groups.

Conclusion

Food intake did not aggravate POPF and did not prolong the length of drain placement or hospital stay after PD. There may be no need to avoid oral dietary intake in patients with POPF.
Appendix
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Metadata
Title
Influence of Food Intake on the Healing Process of Postoperative Pancreatic Fistula After Pancreatoduodenectomy: A Multi-institutional Randomized Controlled Trial
Authors
Tsutomu Fujii, MD, PhD, FACS
Akimasa Nakao, MD, PhD, FACS
Kenta Murotani, PhD
Yukiyasu Okamura, MD, PhD
Kiyoshi Ishigure, MD, PhD
Tsuyoshi Hatsuno, MD, PhD
Mitsuru Sakai, MD, PhD
Suguru Yamada, MD, PhD, FACS
Mitsuro Kanda, MD, PhD
Hiroyuki Sugimoto, MD, PhD
Shuji Nomoto, MD, PhD
Shin Takeda, MD, PhD
Satoshi Morita, PhD
Yasuhiro Kodera, MD, PhD, FACS
Publication date
01-11-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4496-1

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