Meta-analysis Of Feeding Routes After Pancreatoduodenectomy

Objective:To investaget the effect of different nutritional support methods(including total parenteral nutrition,early oral nutrition,early enteral nutrition via nasojejunal tube,early enteral nutrition via gastric fistula,and early enteral nutrition via jejunal fistula)on the prognosis of patients after pancreaticoduodenectomy(PD).Methods: Pubmed,Embase,The Cochrane Library were searched for articles on nutritional support after PD published from 2007 to 2017.A pooled analysis was performed for related data including samples size,research contents,study population,research roadmap and methods,length of hospital stay,and incidence rates of infection,pancreaticfistula,and delayed gastric emptying,and Rev Man 5.3 software was used for the meta-analysis of total parenteral nutrition and early enteral nutirtion via nasojejunal tube after PD.Results:A total of 11 articles involving 3534 PD patients were included,and 4 were included in the meta-analysis.The incidence of pancreatic leakage varied from 9.10 percent to 32.89 percent.The overall delayed gastric emptying rate ranged from 11.7 percent to 38.82 percent.The overall infection mortality rate was lower in the TPN group than enteral nutrition Groups.Meta-analysis showed that there no statistic difference between NJT and TNP groups in complications.Conclusion:There is no evidence to support routine enteral or parenteral feeding after PD.We can choose all the feeding routes strategy according to the particular case after PD.