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Compliance with and effects of preoperative immunonutrition in patients undergoing pancreaticoduodenectomy
Author(s) -
Shirakawa Hirofumi,
Kinoshita Taira,
Gotohda Naoto,
Takahashi Shinichiro,
Nakagohri Toshio,
Konishi Masaru
Publication year - 2012
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0416-3
Subject(s) - pancreaticoduodenectomy , medicine , surgical stress , enteral administration , ingestion , surgery , preoperative care , parenteral nutrition , pancreatectomy , anesthesia , resection
Background/purpose This study was conducted to ascertain the feasibility and effectiveness of preoperative enteral immunonutrition using an immune‐enhanced formula (Impact) in patients undergoing pancreaticoduodenectomy. Methods Twenty‐five patients undergoing an elective pancreaticoduodenectomy were asked to ingest Impact for 5 days (750 mL/day) prior to surgery in addition to their normal diets. We retrospectively compared the early postoperative outcomes of the Impact group ( n = 18), which consisted of patients who fully complied with the study protocol, and a control group ( n = 13), which consisted of patients who had not ingested Impact prior to surgery. Results Overall, 82.6% of the patients complied with the preoperative oral ingestion of Impact; all but four patients tolerated a daily intake of 750 mL. While the clinical backgrounds of the Impact and control groups were not significantly different, the frequency of incisional wound infection was lower (0 vs. 30.8%, p = 0.012) and the change in systemic severity as evaluated using the acute physiology and chronic health evaluation (APACHE)‐II scoring system was milder ( p = 0.033) in the Impact group than in the control group. Conclusion The preoperative oral ingestion of Impact was well tolerated and appeared to be effective for preventing incisional wound infection and reducing the response to surgical stress in patients undergoing a pancreaticoduodenectomy.