Abstract
Objective: The objective of this study was to assess the feasibility and safety of inserting a double-lumen gastrojejunostomy tube (GJT) after pancreaticoduodenectomy (PD) and to evaluate associated outcomes. Background: Gastroparesis is a frequent postoperative event following PD. This often necessitates prolonged gastric decompression and nutritional support. A double-lumen GJT may be particularly useful in this situation: gastric decompression may be achieved through the gastric port without a nasogastric tube; enteral feeding may be administered through the jejunal port. Methods: Thirty-six patients with periampullary tumors were randomized at the time of PD to insertion of GJT or to the routine care of the operating surgeon. Outcomes, including length of stay, complications, and costs, were followed prospectively. Results: The 2 groups had similar characteristics. Prolonged gastroparesis occurred in 4 controls (25%) and in none of the patients who had a GJT (P = 0.03). Complication rates were similar in each group. Mean postoperative length of stay was significantly longer in controls compared with patients who had a GJT (15.8 ± 7.8 days versus 11.5 ± 2.9 days, respectively; P = 0.01). Hospital charges were $82,151 ± 56,632 in controls and $52,589 ± 15,964 in the GJT group (P = 0.036). Conclusions: In patients undergoing PD, insertion of a GJT is safe. Moreover, insertion of a GJT improves average length of stay. At the time of resection of periampullary tumors, GJT insertion should be considered, especially given this is a patient population in which weight loss and cachexia are frequent.
| Original language | English |
|---|---|
| Pages (from-to) | 845-851 |
| Number of pages | 7 |
| Journal | Annals of Surgery |
| Volume | 240 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 1 2004 |
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ASJC Scopus subject areas
- Surgery
Cite this
Gastric decompression and enteral feeding through a double-lumen gastrojejunostomy tube improves outcomes after pancreaticoduodenectomy. / Mack, Lloyd A.; Kaklamanos, Ioannis G.; Livingstone, Alan; Levi, Joe; Robinson, Carolyn; Sleeman, Danny; Franceschi, Dido; Bathe, Oliver F.
In: Annals of Surgery, Vol. 240, No. 5, 01.11.2004, p. 845-851.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gastric decompression and enteral feeding through a double-lumen gastrojejunostomy tube improves outcomes after pancreaticoduodenectomy
AU - Mack, Lloyd A.
AU - Kaklamanos, Ioannis G.
AU - Livingstone, Alan
AU - Levi, Joe
AU - Robinson, Carolyn
AU - Sleeman, Danny
AU - Franceschi, Dido
AU - Bathe, Oliver F.
PY - 2004/11/1
Y1 - 2004/11/1
N2 - Objective: The objective of this study was to assess the feasibility and safety of inserting a double-lumen gastrojejunostomy tube (GJT) after pancreaticoduodenectomy (PD) and to evaluate associated outcomes. Background: Gastroparesis is a frequent postoperative event following PD. This often necessitates prolonged gastric decompression and nutritional support. A double-lumen GJT may be particularly useful in this situation: gastric decompression may be achieved through the gastric port without a nasogastric tube; enteral feeding may be administered through the jejunal port. Methods: Thirty-six patients with periampullary tumors were randomized at the time of PD to insertion of GJT or to the routine care of the operating surgeon. Outcomes, including length of stay, complications, and costs, were followed prospectively. Results: The 2 groups had similar characteristics. Prolonged gastroparesis occurred in 4 controls (25%) and in none of the patients who had a GJT (P = 0.03). Complication rates were similar in each group. Mean postoperative length of stay was significantly longer in controls compared with patients who had a GJT (15.8 ± 7.8 days versus 11.5 ± 2.9 days, respectively; P = 0.01). Hospital charges were $82,151 ± 56,632 in controls and $52,589 ± 15,964 in the GJT group (P = 0.036). Conclusions: In patients undergoing PD, insertion of a GJT is safe. Moreover, insertion of a GJT improves average length of stay. At the time of resection of periampullary tumors, GJT insertion should be considered, especially given this is a patient population in which weight loss and cachexia are frequent.
AB - Objective: The objective of this study was to assess the feasibility and safety of inserting a double-lumen gastrojejunostomy tube (GJT) after pancreaticoduodenectomy (PD) and to evaluate associated outcomes. Background: Gastroparesis is a frequent postoperative event following PD. This often necessitates prolonged gastric decompression and nutritional support. A double-lumen GJT may be particularly useful in this situation: gastric decompression may be achieved through the gastric port without a nasogastric tube; enteral feeding may be administered through the jejunal port. Methods: Thirty-six patients with periampullary tumors were randomized at the time of PD to insertion of GJT or to the routine care of the operating surgeon. Outcomes, including length of stay, complications, and costs, were followed prospectively. Results: The 2 groups had similar characteristics. Prolonged gastroparesis occurred in 4 controls (25%) and in none of the patients who had a GJT (P = 0.03). Complication rates were similar in each group. Mean postoperative length of stay was significantly longer in controls compared with patients who had a GJT (15.8 ± 7.8 days versus 11.5 ± 2.9 days, respectively; P = 0.01). Hospital charges were $82,151 ± 56,632 in controls and $52,589 ± 15,964 in the GJT group (P = 0.036). Conclusions: In patients undergoing PD, insertion of a GJT is safe. Moreover, insertion of a GJT improves average length of stay. At the time of resection of periampullary tumors, GJT insertion should be considered, especially given this is a patient population in which weight loss and cachexia are frequent.
UR - http://www.scopus.com/inward/record.url?scp=7044222459&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7044222459&partnerID=8YFLogxK
U2 - 10.1097/01.sla.0000143299.72623.73
DO - 10.1097/01.sla.0000143299.72623.73
M3 - Article
C2 - 15492567
AN - SCOPUS:7044222459
VL - 240
SP - 845
EP - 851
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
IS - 5
ER -