Early oral feeding after pancreatoduodenectomy: a systematic review and meta-analysis.
Halle-Smith, James M Pande, Rupaly Powell-Brett, Sarah Pathak, Samir Pandanaboyana, Sanjay Smith, Andrew M Roberts, Keith J
Halle-Smith, James M
Pande, Rupaly
Powell-Brett, Sarah
Pathak, Samir
Pandanaboyana, Sanjay
Smith, Andrew M
Roberts, Keith J
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2022-04-26
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Abstract
Background: The effect of early oral feeding (EOF) after pancreatoduodenectomy (PD) upon perioperative complications and outcomes is unknown, therefore the aim of this systematic review and meta-analysis was to investigate the effect of EOF on clinical outcomes after PD, such as postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE) and length of stay (LOS).
Methods: A systematic review and meta-analysis was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and assimilated evidence from studies reporting outcomes for patients who received EOF after PD compared to enteral tube feeding (EN) or parenteral nutrition (PN).
Results: Four studies reported outcomes after EOF compared to EN/PN after PD and included 553 patients. Meta-analyses showed no difference in rates of CR-POPF (OR 0.74; 95%CI 0.44-1.24; p = 0.25) or DGE (Grade B/C) (OR 0.83; 95%CI 0.31-2.21; p = 0.70). LOS was significantly shorter in the EOF group compared to the EN/PN group (Mean Difference -3.40 days; 95% -6.11-0.70 days; p = 0.01).
Conclusion: Current available evidence suggests that EOF after PD is not associated with increased risk of DGE, does not exacerbate POPF and appears to reduce length of stay.
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Halle-Smith JM, Pande R, Powell-Brett S, Pathak S, Pandanaboyana S, Smith AM, Roberts KJ. Early oral feeding after pancreatoduodenectomy: a systematic review and meta-analysis. HPB (Oxford). 2022 Oct;24(10):1615-1621. doi: 10.1016/j.hpb.2022.04.005. Epub 2022 Apr 26
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