Halle-Smith, James MPande, RupalyPowell-Brett, SarahPathak, SamirPandanaboyana, SanjaySmith, Andrew MRoberts, Keith J2023-08-032023-08-032022-04-26Halle-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 261365-182X1477-257410.1016/j.hpb.2022.04.00535606323http://hdl.handle.net/20.500.14200/1573Background: 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.enCopyright © 2022 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.SurgeryArticle