BACKGROUND: The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. METHODS: A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). RESULTS: Of 138 PD patients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). CONCLUSIONS: In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement.
BACKGROUND: The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. METHODS: A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). RESULTS: Of 138 PDpatients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). CONCLUSIONS: In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement.
Authors: Jordan M Winter; John L Cameron; Kurtis A Campbell; Meghan A Arnold; David C Chang; Joann Coleman; Mary B Hodgin; Patricia K Sauter; Ralph H Hruban; Taylor S Riall; Richard D Schulick; Michael A Choti; Keith D Lillemoe; Charles J Yeo Journal: J Gastrointest Surg Date: 2006-11 Impact factor: 3.452
Authors: Marco Braga; Giovanni Capretti; Nicolò Pecorelli; Gianpaolo Balzano; Claudio Doglioni; Riccardo Ariotti; Valerio Di Carlo Journal: Ann Surg Date: 2011-11 Impact factor: 12.969
Authors: David Yu Greenblatt; Kaitlyn J Kelly; Victoria Rajamanickam; Yin Wan; Todd Hanson; Robert Rettammel; Emily R Winslow; Clifford S Cho; Sharon M Weber Journal: Ann Surg Oncol Date: 2011-02-20 Impact factor: 5.344
Authors: Mohammad Abu-Hilal; Anil K Hemandas; Mark McPhail; Gaurav Jain; Ioanna Panagiotopoulou; Tina Scibelli; Colin D Johnson; Neil W Pearce Journal: JOP Date: 2010-01-08
Authors: Arja Gerritsen; Marc G Besselink; Kasia P Cieslak; Menno R Vriens; Elles Steenhagen; Richard van Hillegersberg; Inne H Borel Rinkes; I Quintus Molenaar Journal: J Gastrointest Surg Date: 2012-04-20 Impact factor: 3.452
Authors: Cheguevara Afaneh; Deborah Gerszberg; Eoin Slattery; David S Seres; John A Chabot; Michael D Kluger Journal: Hepatobiliary Surg Nutr Date: 2015-02 Impact factor: 7.293
Authors: Daniel P Nussbaum; Sabino Zani; Kara Penne; Paul J Speicher; Sandra S Stinnett; Bryan M Clary; Rebekah R White; Douglas S Tyler; Dan G Blazer Journal: J Gastrointest Surg Date: 2014-06-25 Impact factor: 3.452