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Routine use of feeding jejunostomy in pancreaticoduodenectomy: A metaanalysis
Author(s) -
Vasavada Bhavin,
Patel Hardik
Publication year - 2021
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12493
Subject(s) - medicine , jejunostomy , pancreaticoduodenectomy , pancreatic fistula , perioperative , gastric emptying , surgery , parenteral nutrition , general surgery , pancreas , stomach , resection
Aims and Objectives The primary aim of our study was to evaluate morbidity and mortality following feeding jejunostomy in pancreaticoduodenectomy compared to the control group. We also evaluated individual complications like delayed gastric emptying; post operative pancreatic fistula, superficial and deep surgical site infection. Material and Methods The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2.the random‐effects model was used. Results Four studies including a total of 1639 patients were included in the analysis. A total of 843 patients were included in the feeding jejunostomy group and 796 patients included in the control group without feeding jejunostomy. Overall morbidity was significantly higher in the feeding jejunostomy group ( P = .001). There was no significant difference in perioperative mortality between both the groups ( P = .07). Delayed gastric emptying was significantly higher in the feeding jejunostomy group ( P = .021). There was no significant difference in development of pancreatic fistula between the two groups. Deep surgical site infection was significantly higher in feeding jejunostomy group. ( P = .013). Hospital stay was significantly more in feeding jejunostomy group ( P < .0001). There was no significant difference between readmission, TPN requirement and time to start oral feed. Conclusion Feeding jejunostomy seems to be associated with increased morbidity and increased length of stay.