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Oral Food Intake Versus Fasting on Postoperative Pancreatic Fistula After Distal Pancreatectomy

机译:远端胰腺切除术后胰瘘的口服食物摄入与禁食

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摘要

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 beneficial or harmful during management of POPF after distal pancreatectomy (DP) is currently available.To investigate the effects of oral food intake on the healing process of POPF after DP.Multi-institutional randomized controlled trial in Nagoya University Hospital and 4 affiliated hospitals.Patients who developed POPF were randomly assigned to the dietary intake (DI) group (n = 15) or the fasted group (no dietary intake [NDI] group) (n = 15). The primary endpoint was the length of drain placement.No significant differences were found in the length of drain placement between the DI and NDI groups (12 [6–58] and 12 [7–112] days, respectively; P = 0.786). POPF progressed to a clinically relevant status (grade B/C) in 5 patients in the DI group and 4 patients in the NDI group (P = 0.690). POPF-related intra-abdominal hemorrhage was found in 1 patient in the NDI group but in no patients in the DI group (P = 0.309). 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.Food intake did not aggravate POPF and did not prolong drain placement or hospital stay after DP. There may be no need to avoid oral DI in patients with POPF.
机译:据报道,通过鼻肠管进行肠内营养对于杂项胰腺切除术后出现胰瘘(POPF)的患者是有用的。然而,目前尚无关于在远端胰腺切除术(DP)后进行POPF处理期间口服摄入是有益还是有害的明确证据,以研究口服食物摄入对DP后POPF愈合过程的影响。多机构随机对照试验在名古屋大学医院和4家附属医院中,发生POPF的患者被随机分配到饮食摄入(DI)组(n = 15)或禁食组(无饮食摄入[NDI]组)(n = 15)。主要终点是引流口的长度。DI组和NDI组之间的​​引流口长度没有显着差异(分别为12 [6-58]天和12 [7-12]天; P = 0.786)。 DI组中有5例患者和NDI组中有4例POPF进展为临床相关状态(B / C级)(P = 0.690)。 NDI组中1例患者发现POPF相关的腹腔内出血,而DI组中无患者(P = 0.309)。两组之间在POPF相关的腹腔内出血,其他并发症的发生率或术后住院时间方面无显着差异。食物摄入并没有加重POPF,并且在DP后没有延长引流或住院时间。 POPF患者可能无需避免口服DI。

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