Introduction: Postoperative pancreatic fistula (POPF) remains one of the main complications following pancreatic resection. Despite pancreatic fistula having a low postoperative mortality rate, the readmission and intervention rates in patients with pancreatic fistula are still considerable. Although there are several studies on pancreatic fistula development after pancreaticoduodenectomy, there are only a few studies on the feeding protocols applied after distal pancreatectomy or enucleation of pancreatic tumours. We designed this trial to test the hypothesis that early feeding does not increase the incidence of POPF and positively influences the long-term prognosis in patients who undergo distal pancreatectomy or enucleation of pancreatic tumours.
Methods And Analysis: This is a prospective randomised controlled trial that will be conducted in a single centre. A total of 106 patients undergoing distal pancreatectomy or enucleation of pancreatic tumours will be recruited after providing informed consent. They will be randomly assigned to either an early or late feeding group. The early feeding group will begin enteral nutrition on postoperative day (POD) 3, and the late feeding group will begin enteral nutrition on POD7. The primary outcome is the incidence of POPF. The secondary outcomes include the length of postoperative hospital stay, postoperative complications, and indicators of long-term prognosis.
Ethics And Dissemination: Peking University Third Hospital Medical Science Research Ethics Committee approved the study (M2021395). Findings will be disseminated in a peer-reviewed journal and in national and/or international meetings to guide future practice.
Trial Registration Number: ChiCTR2100053978.
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http://dx.doi.org/10.1136/bmjopen-2022-068469 | DOI Listing |
ANZ J Surg
January 2025
General Surgical Department, Liverpool Hospital, Corner of Elizabeth and Goulburn Street, Liverpool, New South Wales, 2170, Australia.
Background: Post-operative pancreatic fistula is a common and morbid complication of pancreaticojejunal anastomosis. While gastrointestinal anastomosis is typically performed using absorbable sutures, this issue has prompted experimentation with non-absorbable sutures. This study aims to assess the available literature to provide recommendations on suture choice in this anastomosis.
View Article and Find Full Text PDFLangenbecks Arch Surg
January 2025
Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Purpose: To investigate the risk factors for late postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy (PD), with a focus on positive drain fluid culture (DFC) results on postoperative day (POD) 1.
Methods: Medical records of 198 patients who underwent PD with drain fluid amylase (DFA) on POD 5 < 3x upper limit of normal (ULN) were included. Late POPF was defined as POPF diagnosed post-POD 6, with DFA on POD 5 < 3xULN.
PLoS One
January 2025
Department of Nursing, the Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China.
Objective: The relationship among body mass index (BMI), postoperative complications, and clinical outcomes in patients undergoing gastrectomy for gastric cancer remains unclear. This study aimed to evaluate this association using a meta-analysis.
Method: We conducted a systematic search of the PubMed, Embase, and Cochrane Library databases up to February 25, 2024.
Front Surg
January 2025
Department of Hepato-Pancreato-Biliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
Background: Pancreatic trauma is a rare solid organ injury. Conservative treatment is often indicated in patients with no pancreatic duct injury, while patients with high-grade pancreatic damage most often require surgical intervention. Laparoscopic central pancreatectomy (LCP) is a parenchyma-sparing approach and can prevent endocrine and exocrine insufficiency after pancreatic resection.
View Article and Find Full Text PDFRespir Med Case Rep
January 2025
Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States.
Pancreatopleural fistulas, rare complications of chronic pancreatitis, are often overlooked in the initial differential diagnoses of pleural effusions, resulting in delayed diagnosis and management. We present the case of an elderly male with recurrent pleural effusion and a history of chronic pancreatitis. Diagnostic challenges arose, with the initial misdiagnosis as pneumonia.
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