Analysis Of The Effect Of Probiotics In The Perioperative Period Of Pancreatoduodenectomy

Pancreaticoduodenectomy is the standard procedure for the treatment of tumors around the head of pancreas and ampulla.In recent years,the safety of the operation has been improved significantly.However,due to the complexity of the operation,the destroy of normal anatomical structure of the digestive tract and the gastrointestinal mucosal barrier,abnormal bile secretion,liver function damage,gastrointestinal dysfunction generated from intestinal flora disorders due to the long-term use of large doses of antibiotics,postoperative complications such as intraperitoneal infection,gastric emptying disorder?DGE?are having notable higher incidence then the other abdominal operation^[1].The incidence of postoperative complications is 30%⁴0%^[2],leading to prolonged hospital stay and increased economic expenditure,severe cases can lead to re-operation,or even death.In recent years,as a new life science,microecology is developing continuously,and its research and application fields are more and more extensive3.The application of probiotics in microecology in health care,disease prevention and treatment has important theoretical and practical significance.The complications after pancreaticoduodenectomy,low immunity after operation,fasting and no recovery of gastrointestinal function may lead to intestinal flora imbalance,bacterial translocation induced systemic infection,malnutrition and other complications,even septicemia and life-threatening situation^[3].Intestinal microecological preparations?Microbio-ecological Preparation,MBP?have been reported having the positive effect of adjusting intestinal flora imbalance,improving the immune function of patients with abnormal liver function and receiving digestive tract operation and promoting postoperative recovery^[4].But whether intestinal probiotics can reduce gastrointestinal complications after pancreaticoduodenectomy is not clear,combined with the positive effects of intestinal probiotics.Therefore,this study explored the effect of early enteral nutrition combinedwithprobioticsonperioperativepatientsundergoing pancreaticoduodenectomy,hoping to find a new treatment to reduce the complications associated with pancreatoduodenectomy.Objective:The purpose of this study was to explore the effect of early enteral nutrition combined with probiotics on perioperative patients undergoing pancreaticoduodenectomy,in order to understand the efficacy and feasibility of probiotics on perioperative patients undergoing pancreaticoduodenectomy.It also intends to provide reliable evidence for finding new treatment methods that can reduce complications associated with pancreaticoduodenectomy.Methods:A prospective double-blind randomized controlled trial was conducted to study 89 patients undergoing pancreaticoduodenectomy from October 2016 to December 2017 in the Renmin Hospital of Zhengzhou University.The patients are divided into experimental groups according to whether to use probiotic preparation during perioperative period,experimental group?group A,n=30?or control group?group B,n=43?.The the indexes of liver function and inflammatory reaction,the incidence of complications,the time of extubation of drainage tube and the time of hospitalization after operation were compared between the two groups so as to evaluate recovery of each.Results:The recovery of inflammatory indexes in group A was faster than that in group B.?P<0.05?.But there was no significant difference in coagulation function between the two groups.?P>0.05?;there was no significant statistical difference in postoperative drainage between the two groups.?P>0.05?;but the extubation time of drainage tube in group A was earlier than that in group B.?P<0.01?;average hospital stay in group A was shorter than that in group B.?P<0.05?.The incidence of complications such as postoperative abdominal infection,pancreatic fistula and gastric emptying disorder?DGE?in group A was lower than that in group B,and the difference was statistically significant.?P<0.05?.There was no death in both groups.Conclusion:The application of probiotics in perioperative period of pancreaticoduodenectomy can accelerate the recovery of liver function,reduce postoperative inflammatory reaction,reduce the incidence of complications of abdominal infection and gastric emptying disorder?DGE?.Shortening hospital stay,and accelerating postoperative rehabilitation.It worth further promotion.