J Korean Surg Soc.  2011 Oct;81(4):257-262. 10.4174/jkss.2011.81.4.257.

Is routine nasogastric tube insertion necessary in pancreaticoduodenectomy?

• Choi YY
• Kim J
• Seo D
• Choi D
• Kim MJ
• Kim JH
• Lee KJ
• Hur KY

• KMID: 1445746
• DOI: http://doi.org/10.4174/jkss.2011.81.4.257

Abstract

PURPOSE
The necessity of nasogastric decompression after abdominal surgical procedures has been increasingly questioned for several years. Traditionally, nasogastric decompression is a mandatory procedure after classical pancreaticoduodenectomy (PD); however, we still do not know whether or not it is necessary for PD. The present study was designed to assess the clinical benefit of nasogastric decompression after PD.
METHODS
Between July 2004 and May 2007, 41 consecutive patients who underwent PD were enrolled in this study. Eighteen patients were enrolled in the nasogastric tube (NGT) group and 23 patients were enrolled in the no NGT group.
RESULTS
There were no differences in the demographics, pathology, co-morbid medical conditions, and pre-operative laboratory values between the two groups. In addition, the passage of flatus (P = 0.963) and starting time of oral intake (P = 0.951) were similar in both groups. In the NGT group, 61% of the patients complained of discomfort related to the NGT. Pleural effusions were frequent in the NGT group (P = 0.037); however, other post-operative complications, such as wound dehiscence and anastomotic leakage, occurred similarly in both groups. There was one case of NGT re-insertion in the NGT group.
CONCLUSION
Routine nasogastric decompression in patients undergoing PD is not mandatory because it has no clinical advantages and increases patient discomfort.

Keyword

Pancreaticoduodenectomy; Gastrointestinal intubation

MeSH Terms

Anastomotic Leak
Decompression
Demography
Flatulence
Humans
Intubation, Gastrointestinal
Pancreaticoduodenectomy
Pleural Effusion

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