Abstract
Aim. To examine the efficiency of perioperative enteral nutrition in patients with chronic pancreatitis who underwent elective pancreatectomy. Material and methods. Prospective randomized study of the effect of early enteral nutrition on the results of surgical treatment of chronic pancreatitis has been conducted for the period from January to December 2017. In the main group 20 patients received Peptamen AF 3 days before surgery and 5 days after in addition to parenteral nutrition. Only parenteral postoperative nutrition was prescribed in 20 patients of the control group. Morbidity, ICU-stay and hospital-stay, peristalsis onset timing and protein metabolism markers (serum albumin, transferrin) were assessed. Results. There was a significant increase of the level of transferrin, albumin and lymphocytes after 5 and 10 days in the main group postoperatively (p < 0.001). Significantly earlier onset of peristalsis (1,5 [1; 2] compared with 3,5 [2; 5] days, p = 0.002) and earlier stool (4 [3; 5] and 6.5 [4; 7] days, p = 0.002) were also revealed in the main group. Incidence of anastomotic leakage and intra-abdominal infection was less in the main group (p = 0.31). ICU-stay and hospital-stay were also significantly shorter in the main group (12.5 and 18.5 days, p = 0.001). Conclusion. Perioperative enteral nutrition by using of Peptamen AF decreases postoperative morbidity, hospital-stay and cost of treatment.
Highlights
There was a significant increase of the level of transferrin, albumin and lymphocytes after 5 and 10 days in the main group postoperatively (p < 0.001)
Postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition
Enteral compared with parenteral nutrition: A meta-analysis
Summary
В основной группе 20 больных помимо стандартного ПП получали до и после операции ЭП. Всем пациентам на протяжении 7 дней после операции назначали блокаторы Н2-рецепторов гистамина для профилактики стрессовых язв и октреотид по 0,1 мг 3 раза в сутки подкожно в течение 5 дней. Использовали схему до- и послеоперационного питания “3+5”: в течение 3 дней накануне операции пациенты основной группы, наряду с обычным питанием через рот, дополнительно принимали 500 мл смеси Peptamen AF 750 ккал/сут. Лабораторные данные питательного статуса (общий белок, альбумин, трансферрин, общее число лимфоцитов) оценивали перед операцией, на 5-е и 10-е сутки после операции. При оценке клинических показателей отмечено достоверно более раннее начало перистальтики и появление первого стула у пациентов основной группы В 1 наблюдении при желудочно-кишечном кровотечении (класс А по ISGPS) предпринят эндоскопический гемостаз
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