TY - JOUR
T1 - Routine Gastric Decompression after Pancreatoduodenectomy
T2 - Treating the Surgeon?
AU - Flick, K. F.
AU - Soufi, M.
AU - Yip-Schneider, M. T.
AU - Simpson, R. E.
AU - Colgate, C. L.
AU - Nguyen, T. K.
AU - Ceppa, E. P.
AU - House, M. G.
AU - Zyromski, N. J.
AU - Nakeeb, A.
AU - Schmidt, C. M.
N1 - Publisher Copyright:
© 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
PY - 2021/11
Y1 - 2021/11
N2 - Background: The decision to routinely leave a nasogastric tube after pancreatoduodenectomy remains controversial. We sought to determine the impact of immediate nasogastric tube removal versus early nasogastric tube removal (<24 h) on postoperative outcomes. Methods: A retrospective review of our institution’s prospective ACS-NSQIP database identified patients that underwent pancreatoduodenectomy from 2015 to 2018. Outcomes were compared among patients with immediate nasogastric tube removal versus early nasogastric tube removal. Results: A total of 365 patients were included in primary analysis (no nasogastric tube, n = 99; nasogastric tube removed <24 h, n = 266). Thirty-day mortality and infectious, renal, cardiovascular, and pulmonary morbidity were similar in comparing those with no nasogastric tube versus early nasogastric tube removal on univariable and multivariable analyses (P > 0.05). Incidence of delayed gastric emptying (11.1 versus 13.2%) was similar between groups. Patients with no nasogastric tube less frequently required nasogastric tube reinsertion (n = 4, 4%) compared to patients with NGT <24 h (n = 39, 15%) (OR = 3.83, 95% CI [1.39-10.58]; P = 0.009). Conclusion: Routine gastric decompression can be safely avoided after uneventful pancreaticoduodenectomy.
AB - Background: The decision to routinely leave a nasogastric tube after pancreatoduodenectomy remains controversial. We sought to determine the impact of immediate nasogastric tube removal versus early nasogastric tube removal (<24 h) on postoperative outcomes. Methods: A retrospective review of our institution’s prospective ACS-NSQIP database identified patients that underwent pancreatoduodenectomy from 2015 to 2018. Outcomes were compared among patients with immediate nasogastric tube removal versus early nasogastric tube removal. Results: A total of 365 patients were included in primary analysis (no nasogastric tube, n = 99; nasogastric tube removed <24 h, n = 266). Thirty-day mortality and infectious, renal, cardiovascular, and pulmonary morbidity were similar in comparing those with no nasogastric tube versus early nasogastric tube removal on univariable and multivariable analyses (P > 0.05). Incidence of delayed gastric emptying (11.1 versus 13.2%) was similar between groups. Patients with no nasogastric tube less frequently required nasogastric tube reinsertion (n = 4, 4%) compared to patients with NGT <24 h (n = 39, 15%) (OR = 3.83, 95% CI [1.39-10.58]; P = 0.009). Conclusion: Routine gastric decompression can be safely avoided after uneventful pancreaticoduodenectomy.
KW - Delayed gastric emptying
KW - Nasogastric decompression
KW - Pancreatoduodenectomy
UR - http://www.scopus.com/inward/record.url?scp=85103356805&partnerID=8YFLogxK
U2 - 10.1007/s11605-021-04971-w
DO - 10.1007/s11605-021-04971-w
M3 - Article
C2 - 33772404
AN - SCOPUS:85103356805
SN - 1091-255X
VL - 25
SP - 2902
EP - 2907
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 11
ER -