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EVALUATION OF RESULTS OF ERAS PROGRAM AFTER PANCREATODUODENECTOMY DEPENDING ON THE TYPE OF GASTROINTESTINAL RECONSTRUCTION.

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OBJECTIVE The aim: To assess the effect of gastrojejunostomy with Braun anastomosis during PD for prevention of DGE in ERAS protocol patients. PATIENTS AND METHODS Materials and methods: A total… Click to show full abstract

OBJECTIVE The aim: To assess the effect of gastrojejunostomy with Braun anastomosis during PD for prevention of DGE in ERAS protocol patients. PATIENTS AND METHODS Materials and methods: A total of 92 patients from 28 to 75 years were included in this study, who underwent PD with ERAS program. Patients were divided into 2 groups, depending on type of reconstruction - PD with Child reconstruction and PD with gastrojejunostomy with Braun anastomosis. RESULTS Results: In non-Braun group nasogastric tube was removed on POD 1 in 56 (93.3%) patients and was reinserted later in 4 (6.7%) patients. DGE was observed in 8 (13,3%) patients, which required enteral feeding via nasojejunal tube. In 51 (85.0%) patients feeding was started according to ERAS program without the need for other methods of nutritional support. In Braun group nasogastric tube was removed on POD 1 in all patients after the X-ray control and oral feeding was started. Due to the development of DGE, a nasojejunal tube for enteral nutrition was placed in two cases. In 30 (93,7%) patients peroral feeding was started in accordance to enhanced recovery program. Thus, the frequency of DGE in group II was lower (6.3%), but the difference did not reach statistical significance (p = 0.299). CONCLUSION Conclusions: The formation of a Braun anastomosis in PD with the use of ERAS program can reduce the frequency of DGE and eliminate the consequences of technical errors. More studies are needed for stronger evidence.

Keywords: program; depending type; dge; reconstruction; eras program; tube

Journal Title: Wiadomosci lekarskie
Year Published: 2022

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