An Elemental Diet Reduces Chylous Ascites of Patients Undergoing Pancreatoduodenectomy in the Setting of Early Enteral Feeding.

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pancreas Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI:10.1097/MPA.0000000000002309

Masaru Matsumura, Yoshihiro Mise, Nobuyuki Takemura, Yoshihiro Ono, Takafumi Sato, Hiromichi Ito, Yosuke Inoue, Yu Takahashi, Akio Saiura

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Abstract

Objectives: The elemental diet (ED) is a formula to support nutritional status without increasing chylous burden. This study evaluates the efficacy of early ED feeding after pancreatoduodenectomy (PD).

Materials and methods: A prospective phase II study of consecutive patients who underwent PD with early ED feeding was conducted. Patient backgrounds, surgical outcomes, and ED feeding tolerability were compared with a historical cohort of 74 PD patients with early enteral feeding of a low residue diet (LRD).

Results: The ED group comprised 104 patients. No patient in the ED group discontinued enteral feeding because of chylous ascites (CAs), whereas 17.6% of the LRD group experienced refractory CAs that disrupted further enteral feeding. The CAs rate was significantly decreased in the ED group compared with the LRD group (3.9% and 48.7%, respectively; P < 0.001). There was no significant difference in the incidence of major complications (ED: 17.3%, LRD: 18.9%; P = 0.844). Postoperative prognostic nutritional index was similar between the 2 groups ( P = 0.764). In multivariate analysis, enteral feeding formula, and sex were independent risk factors for CAs (LRD: P < 0.001, odds ratio, 22.87; female: P = 0.019, odds ratio, 2.78).

Conclusions: An ED reduces postoperative CAs of patients undergoing PD in the setting of early enteral feeding.

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在早期肠内喂养的情况下，元素饮食可减少胰十二指肠切除术患者的乳糜腹水。

目的：元素饮食（ED）是一种在不增加胆汁负担的情况下支持营养状况的配方。本研究评估了胰十二指肠切除术（PD）后早期 ED 喂养的疗效：对连续接受胰十二指肠切除术并进行早期 ED 喂养的患者进行了一项前瞻性 II 期研究。将患者背景、手术结果和 ED 喂养耐受性与 74 例早期低渣饮食（LRD）肠道喂养的胰腺十二指肠切除术患者进行比较：ED 组有 104 名患者。ED 组中没有患者因乳糜腹水（CAs）而中断肠内喂养，而 LRD 组中有 17.6% 的患者因难治性 CAs 而中断进一步肠内喂养。与 LRD 组相比，ED 组的 CAs 发生率明显降低（分别为 3.9% 和 48.7%；P <0.001）。主要并发症的发生率没有明显差异（ED：17.3%，LRD：18.9%；P = 0.844）。两组患者的术后预后营养指数相似（P = 0.764）。在多变量分析中，肠内喂养配方和性别是 CAs 的独立风险因素（LRD：P < 0.001，几率为 22.87；女性：P = 0.019，几率为 2.78）：结论：在早期肠内喂养的情况下，ED可减少腹腔镜手术患者术后CA的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.