Previous upper abdominal surgery is a risk factor for nasoga
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Pancreaticoduodenectomy without subsequent nasogastric tube management has not been widely adopted due to delayed gastric emptying, the specific and frequent morbidity associated with this surgical procedure. According to this study pancreaticoduodenectomy without the use of nasogastric tubes is feasible.

Researchers assessed the feasibility of pancreaticoduodenectomy without the use of nasogastric tubes and the risk factors for subsequent nasogastric tube reinsertion.

Investigators retrospectively reviewed 465 patients who underwent pancreaticoduodenectomy at a single institution. The primary endpoint was the rate of nasogastric tube reinsertion. Logistic regression analysis was used to determine independent risk factors of nasogastric tube reinsertion and delayed gastric emptying.

--The rate of nasogastric tube reinsertion was 10.1%. The rate of delayed gastric emptying was 9.5%.

--Logistic regression analysis identified 4 independent risk factors for nasogastric tube reinsertion: male sex, comorbidity of cardiac ischemia, preoperative cholangitis or cholecystitis, and previous upper abdominal surgery.

--Independent risk factors for delayed gastric emptying were male sex, comorbidity of cardiac ischemia, concomitant organ resection, and previous upper abdominal surgery.

Conclusively, pancreaticoduodenectomy without use of nasogastric tubes is feasible, but patients with previous upper abdominal surgery require careful postoperative nasogastric tube management.

Surgery
Source: https://doi.org/10.1016/j.surg.2021.03.059
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