Early vs Conventional Oral Feeding after Pancreaticoduodenectomy: A Prospective Observational Study
Year: 2025
Type: article
Abstract: Background: Enhanced recovery after surgery (ERAS) protocols following pancreaticoduodenectomy (PD) have shown promising results.In all previous studies on ERAS following PD; the earliest oral feeding (liquids only) was started on the first postoperative day; our objective was to start oral (liquid and soft) feed at 6 hours of surgery and assess its effect on postoperative outcome.Materials and methods: All 26 patients (Group-I) undergoing PD from November 2021 to June 2022 were prospectively enrolled and subjected to early oral feeding (EOF), i.e., oral feed at 6 hours.They were compared with a retrospective cohort (Group-II) of 40 patients who received conventional oral feeding (COF) i.e., by feeding jejunostomy on day 1.Results: Age, intraoperative blood loss, and operative time were comparable.Time to start oral liquid (0 vs 1.5 ± 1.2 days, p = 0.00), soft diet (0 vs 3.8 ± 1.9 days, p = 0.00) and solid diet (3.1 ± 0.5 vs 7.2 ± 2.9 days, p = 0.00) was significantly shorter in EOF group.Nasogastric (NG) tube removal was earlier (1.6 ± 1.5 vs 3.9 ± 1.7 days, p 0.00) and required reinsertion less frequently in the EOF group.First stool passage time (3.7 ± 0.9 vs 5.9 ± 1.8 days, p 0.00) and stoppage of intravenous fluids (3.4 ± 0.8 vs 5.2 ± 1.8 days, p 0.00) were significantly earlier in EOF group.The length of postoperative hospital stay was less (5.9 ± 2.6 vs 8.8 ± 4.1 days, p 0.007) in the EOF group.There was no significant difference in postoperative complications, 90-day mortality, and readmission rates between the two groups.Conclusion: Early oral feeding after PD is feasible, safe, and reduces hospital stay.
Institution: All India Institute of Medical Sciences Jodhpur
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411520288