Clinical Application Of Early Enteral Nutrition After Pancreatoduodenectomy

Objective:This study was aimed to investigate the clinical efficacy of early enteral nutrition after pancreaticoduodenectomy by comparing the postoperative pancreaticoduodenectomy patients receiving total parenertal nutrition therapy and early enteral nutrition combined with parenteral nutrition therapy in postoperative anus exhaust time,postoperative complications rate,and postoperative laboratory testing,postoperative hospital stay and medical costs,etc.Methods:A retrospective analysis of 81 patients undergoing pancreatoduodenectomy between September 2015 and September 2017 at the First Affiliated Hospital of Zhengzhou University,which was divided into two groups according to their nutritional support therapy: Thirty-five patients in the control group were treated with total parenteral nutrition and 46 patients in the observation group receiving early enteral nutrition combined with parenteral nutrition.The clinical data of two groups were collected including the clinical observation data,the length of hospital stay and clinical medical expenses,and the relevant data of the patients’ laboratory testing indexes.Results:General indicators: There was no significant difference in the ratio of males and females,average age(years)and primary disease between the control group and the observation group(P>0.05).Laboratory test indicators: There was no significant difference in the mean total protein,albumin,prealbumin,and lymphocyte levels before and after surgery in the observation group and the control group(P>0.05).The average total protein,albumin,prealbumin,and lymphocyte levels after surgery in both groups were lower than before surgery,and they increased with time.The average total protein,prealbumin,and lymphocyte levels in the observation group after surgery were higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in average albumin levels between the two groups(P>0.05).Clinical observations: There were no deaths after surgery in both groups,and there were no reoperations.Anal Exhaust Time: In the observation group,the mean postoperative anus exhaust time was 1.9±1.5 days,and the control group was 3.1±1.8 days.The postoperative anus exhaust in the observation group was 1 day earlier than that of the control group,and there was a difference between the two groups.Statistical significance(P<0.05).Postoperative complications: There were no significant differences in postoperative complications such as gastrointestinal anastomotic leakage,bile duct leakage,pancreatic leakage,delayed incision healing,gastric retention,etc.(P>0.05).Hospitalization time and clinical cost: In the observation group,the postoperative hospital stay was 14.2±6.6 days,and the control group was 16.5±7.1 days.The average postoperative hospital stay was 2 days shorter in the observation group than in the observation group,and the difference between the two groups was statistically significant(P<0.05).The postoperative clinical costs of the observation group were 8.6±4.4(ten thousand yuan),compared with 10.6±7.88(ten thousand yuan)in the control group.The average postoperative clinical costs in the observation group was lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05)..Conclusion:Early enteral nutrition therapy combined with parenteral nutrition therapy after pancreatoduodenectomy can promote gastrointestinal motility,shorten the anal exhaust time,promote a better recovery of the total protein,prealbumin,and lymphocyte levels,and shorten hospital stay,reduced medical costs.The clinical application of early enteral nutrition after pancreatoduodenectomy is safe and reliable.