BACKGROUND An appropriate nutritional support is an important consideration for patients undergoing pancreaticoduodenectomy (PD). Recently, early enteral nutrition (EEN) has been considered to be more effective than total parenteral nutrition (TPN) for the early recovery of patients after many digestive tract surgeries. However, there is little evidence to support EEN in patients undergoing PD. METHODS A systematic literature review was performed to identify relevant studies before December 2018. Statistical analysis was carried out using Review Manager 5.3. RESULTS Nine studies with 1258 patients were included in the meta-analysis. Six studies compared EEN and TPN and three compared two strategies combined vs. a single strategy. The length of hospital stay (LOS) in the EEN group was significantly shorter than that in the TPN group (P < 0.001). There was no difference in the risk of postoperative complications, infections, and mortality between the EEN and TPN groups. In the comparison of two combined strategies vs. one, no significant difference was seen in overall postoperative complications, LOS, or mortality. CONCLUSION Compared with TPN, EEN is a safe strategy and can substantially shorten the LOS of patients.

中文翻译：

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对胰十二指肠切除术后早期肠内营养与总肠胃外营养的影响进行荟萃分析。

背景技术对于进行胰十二指肠切除术（PD）的患者来说，适当的营养支持是重要的考虑因素。最近，在许多消化道手术后，早期肠内营养（EEN）被认为比总肠胃外营养（TPN）更有效。但是，几乎没有证据支持PD患者接受EEN。方法在2018年12月之前进行了系统的文献综述，以鉴定相关研究。使用Review Manager 5.3进行统计分析。结果荟萃分析包括9项1258例患者的研究。六项研究对EEN和TPN进行了比较，三项对两种策略相结合，而对单一策略进行了比较。EEN组的住院时间（LOS）明显短于TPN组的住院时间（P <0。001）。EEN和TPN组之间的术后并发症，感染和死亡率的风险没有差异。在两种联合策略与一种策略的比较中，总体术后并发症，LOS或死亡率没有显着差异。结论与TPN相比，EEN是一种安全策略，可以大大缩短患者的LOS。