Routine Gastric Decompression after Pancreatoduodenectomy: Treating the Surgeon?
Decompression
Surgeons
Pancreatoduodenectomy
Pancreaticoduodenectomy
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Gastric Emptying
Humans
Prospective Studies
Delayed gastric emptying
Intubation, Gastrointestinal
Nasogastric decompression
Retrospective Studies
DOI:
10.1007/s11605-021-04971-w
Publication Date:
2021-03-26T21:02:36Z
AUTHORS (11)
ABSTRACT
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.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.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).Routine gastric decompression can be safely avoided after uneventful pancreaticoduodenectomy.
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