Background

The aim of the present study was to evaluate the impact of routine NGT decompression after PD on postoperative outcomes in the era of an enhanced recovery after surgery (ERAS) protocol.

Materials and methods

A retrospective review of all patients undergoing PD between January 2015 and October 2017 at our institution was performed comparing routine post-operative NGT decompression versus omission. The incidence of delayed gastric emptying, post-operative pancreatic fistula, hospital length of stay, operative time, 30-day readmission rate as well the time to first oral intake were evaluated.

Results

Out of 149 patients who underwent PD, 65 maintained post-operative NGT decompression while post-operative NGT decompression was omitted in 84 patients. No differences were noted in delayed gastric emptying rates (both p>0.05). The median length of stay (9 days for NGT group versus 8.5 days for no NGT group) and 30-day readmission rates (13.8% versus 15.5%, respectively) were similar (p=0.781). Compared with patients who had routine post-operative NGT placed, those who had omission of a post-operative NGT had a lower need for reinsertion, shorter time to PO intake, and a lower likelihood of extended length of stay.

Conclusions

In the era of ERAS protocols, we observed no association between routine post-operative NGT decompression after PD and improved postoperative outcomes.

中文翻译：

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胰十二指肠切除术后无需经验性鼻胃减压

背景

本研究的目的是评估在加速术后恢复 (ERAS) 协议时代，PD 后常规 NGT 减压对术后结果的影响。

材料和方法

我们对 2015 年 1 月至 2017 年 10 月期间在我们机构接受 PD 的所有患者进行了回顾性研究，比较了常规术后 NGT 减压与不手术。评估胃排空延迟、术后胰瘘、住院时间、手术时间、30天再入院率以及首次口服时间。

结果

在接受 PD 的 149 名患者中，65 名维持术后 NGT 减压，而 84 名患者省略了术后 NGT 减压。延迟胃排空率没有差异（均p>0.05）。中位住院时间（NGT 组 9 天，非 NGT 组 8.5 天）和 30 天再入院率（分别为 13.8% 和 15.5%）相似（p=0.781）。与常规术后 NGT 放置的患者相比，未进行术后 NGT 的患者重新置入的需求较低，接受 PO 的时间较短，并且延长住院时间的可能性较低。

结论

在 ERAS 协议时代，我们观察到 PD 后常规术后 NGT 减压与改善术后结果之间没有关联。