Efficacy of Enteral Nutrition by Double Elementary Diet Tube after Pylorus-Preserving Pancreatoduodenectomy

Abstract

Nutritional support after pylorus-preserving pancreaticoduodenectomy (PpPD) is still controversial. This study aimed to evaluate the efficacy of enteral nutrition (EN) via the double elementary diet (W-ED) tube after PpPD. One hundred two patients who received EN by the W-ED tube were compared with 52 patients who received total parental nutrition (TPN) previously. Clinicopatho-logical and postoperative features were analyzed among the two groups. Patients with EN by the W-ED tube after PpPD had a lower incidence of postoperative pancreatic fistula than those with TPN. The total protein and albumin levels on discharge in the EN group were significantly higher than those in the TPN group. In the case without complication, decreasing rate of the third lumbar vertebra skeletal muscle area was significantly lower in the EN group. In the cases of soft pancreas, drainage volume by the W-ED tube until four postoperative day was significantly larger in the case without postoperative pancreatic fistula. The W-ED tube offers the advantages of reducing gastrointestinal pressure and enabling reduction of complications after PpPD surgery.

Successful management of gastric remnant necrosis after proximal gastrectomy using a double elementary diet tube: a case report

“…The usefulness of the W-ED tube for postoperative nutritional management after abdominal surgery has been reported [12]. This particular study compared the postoperative features of patients who received enteral nutritional management using the W-ED tube after pylorus-preserving pancreatoduodenectomy with those Tip holes for nutriƟon Side holes for drainage manufactured by Covidien Japan): a double-lumen tube with tip holes for enteral feeding and side holes for drainage 40 cm from the tip who were previously managed using total parental nutrition (TPN).…”

“…Although reports of gastric remnant necrosis after gastrectomy have been rare [3][4][5][6][7], mortality rates have been considerably high when present [6,7]. A double elementary diet (W-ED) tube, which can be used for both enteral feeding and gastrointestinal tract decompression [8][9][10][11], had been developed for anastomotic leakage and postoperative nutritional management after upper gastroenterological surgery [8][9][10][11][12]. Herein, we report a case of gastric remnant necrosis after proximal gastrectomy that was successfully managed through conservative treatment with a W-ED tube.…”