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Pancreas

Postoperative pancreatic fistula: use of enteral nutrition

Conservative treatment of high-output postoperative pancreatic fistulas (POPFs) includes prolonged fasting with nutritional support. However, the choice between enteral and parenteral nutrition is arbitrary. A randomized clinical trial that compared these two types of nutritional support has demonstrated that enteral feeding is associated with a substantially higher closure rate and a shorter time to closure of POPFs.

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References

  1. Veillette, G. et al. Implications and management of pancreatic fistulas following pancreaticoduodenectomy: The Massachusetts General Hospital experience. Arch. Surg. 143, 476–481 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pedrazolli, S. et al. Postoperative pancreatic fistulas: preventing severe complications and reducing reoperation and moratlity rate. Ann. Surg. 249, 97–104 (2009).

    Article  Google Scholar 

  3. Mahvi, D. Defining, controlling, and treating a pancreatic fistula. J. Gastrointest. Surg. 13, 1187–1188 (2009).

    Article  PubMed  Google Scholar 

  4. Klek, S. et al. Enteral and parenteral nutrition in the conservative treatment of pancreatic fistula: a randomized clinical trial. Gastroenterology doi:10.1053/j.gastro.2011.03.040.

    Article  Google Scholar 

  5. Bassi, C. et al. Early versus late drain removal after standard pancreatic resections: results of a prospective randomized trial. Ann. Surg. 252, 207–214 (2010).

    Article  PubMed  Google Scholar 

  6. Aranha, G. V., Aaron, J. M., Shoup, M. & Pickleman, J. Current management of pancreatic fistula after pancreaticoduodenectomy. Surgery 140, 561–568 (2006).

    Article  PubMed  Google Scholar 

  7. Fan, B. G. Effects of parenteral nutrition on the exocrine pancreas in response to cholecystokinin. JPEN J. Parenter. Enteral Nutr. 32, 57–62 (2008).

    Article  PubMed  Google Scholar 

  8. Bassi, C. et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138, 8–13 (2005).

    Article  PubMed  Google Scholar 

  9. Qin, H. L., Su, Z. D., Zou, Y. & Fan, Y. B. Effect of parenteral and enteral nutrition combined with octreotide on pancreatic exocrine secretion of patients with pancreatic fistula. World J. Gastroenterol. 10, 2419–2422 (2004).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Li-Ling, J. & Irving, M. Somatostatin and octreotide in the prevention of postoperative pancreatic complications and the treatment of enterocutaneous pancreatic fistulas: a systematic review of randomized controlled trials. Br. J. Surg. 88, 190–199 (2001).

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Claudio Bassi.

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Bassi, C., Malleo, G. Postoperative pancreatic fistula: use of enteral nutrition. Nat Rev Gastroenterol Hepatol 8, 427–428 (2011). https://doi.org/10.1038/nrgastro.2011.113

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