ArticleAnnals of medicine and surgery (2012)2016
Early combined parenteral and enteral nutrition for pancreaticoduodenectomy - Retrospective cohort analysis.
Article in Annals of medicine and surgery (2012), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Pooled it
- Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019.World journal of surgery · 2020Pooled it
- The effect of supplementary parenteral nutrition with different energy intakes on clinical outcomes of patients after gastric cancer surgery.BMC surgery · 2024Article
- A clinical study on gastric cancer patients administered EN and PN versus PN alone in enhanced recovery after surgery.Annals of medicine and surgery (2012) · 2024Article
- Friend or foe? Feeding tube placement at the time of pancreatoduodenectomy: propensity score case-matched analysis.Surgical endoscopy · 2022Article
- Development of a nutritional index to evaluate the effectiveness of total parenteral nutrition during the early postoperative period after pancreaticoduodenectomy.Gland surgery · 2021Article
- Nutritional assessment and surgical outcomes in very elderly patients undergoing pancreaticoduodenectomy: a retrospective study.Surgery today · 2021Article
- Comparison of different feeding regimes after pancreatoduodenectomy - a retrospective cohort analysis.Nutrition journal · 2017Article
- [Evidence-based supportive measures to secure pancreatic anastomoses].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2017Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSuggested guidelines for nutritional support after pancreaticoduodenectomy are still controversial. Recent evidence suggests that combining enteral nutrition (EN) with parenteral nutrition (PN) improves outcome. For ten years, patients have been treated with Early Combined Parenteral and Enteral Nutrition (ECPEN) after PD. The aim of this study was to report on rationale, safety, effectiveness and outcome associated with this method.
methodsConsecutive PD performed between 2003 and 2012 were analyzed retrospectively. Early EN and PN was standardized and started immediately after surgery. EN was increased to 40 ml/h (1 kcal/ml) over 24 h, while PN was supplemented based on a daily energy target of 25 kcal/kg. Standard enteral and parenteral products were used.
resultsSixty-nine patients were nutritionally supplemented according to ECPEN. The median coverage of kcal per patients related to the total caloric requirements during the entire hospitalization (nutrition balance) was 93.4% (range: 100%-69.3%). The nutritional balance in patients with needle catheter jejunostomy (NCJ) was significantly higher than in the group with nasojejunal tube (97.1% vs. 91.6%; p < 0.0001). Mortality rate was 5.8%, while major complications (Clavien-Dindo 3-5) occurred in 21.7% of patients. Neither the presence of preoperative malnutrition nor the application of preoperative immunonutrition was associated with postoperative clinical outcome.
conclusionThis is the first European study of ECPEN after PD. ECPEN is safe and, especially in combination with NCJ, provides comprehensive coverage of caloric requirements during the postoperative phase. Clinical controlled trials are needed to investigate potential benefits of complete energy supplementation during the early postoperative phase after PD.
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