Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Routine Use of Feeding Jejunostomy in Pancreaticoduodenectomuy: A Metaanalysis

Version 1 : Received: 7 June 2020 / Approved: 9 June 2020 / Online: 9 June 2020 (04:09:43 CEST)
Version 2 : Received: 3 September 2020 / Approved: 5 September 2020 / Online: 5 September 2020 (06:33:29 CEST)

How to cite: Vasavada, B.; Patel, H. Routine Use of Feeding Jejunostomy in Pancreaticoduodenectomuy: A Metaanalysis. Preprints 2020, 2020060114 (doi: 10.20944/preprints202006.0114.v1). Vasavada, B.; Patel, H. Routine Use of Feeding Jejunostomy in Pancreaticoduodenectomuy: A Metaanalysis. Preprints 2020, 2020060114 (doi: 10.20944/preprints202006.0114.v1).

Abstract

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. We also looked for time to start oral nutrition and requirement of total parentral nutrition. Material and Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. [9,10]. We searched pubmed, cochrane library, embase, google scholar with keywords like “feeding jejunostomy in pancreaticodudenectomy”, “entral nutrition in pancreaticoduodenectomy, “total parentral nutrition in pancreaticoduodenectomy’, “morbidity and mortality following pancreaticoduodenectomy”. Two independent authors extracted the data (B.V and H.P).The meta-analysis was conducted using Open meta-analysis software. Heterogeneity was measured using Q tests and I2, and p < 0.10 was determined as significant , the random-effects model was used. The Odds ratio (OR) was calculated for dichotomous data, and weighted mean differences (WMD) were used for continuous variables. Both differences were presented with 95% CI. Results: Four studies including Total of 1639 patients were included in the analysis. Total 843 patients were included in Feeding jejunostomy group and 796 patients included in control group without feeding jejunostomy. Over all morbidity was significantly higher in feeding jejunostomy group. (odds ratio 1.39, p = 0.001). However, there was no significant difference between both the group. (p=0.07). Delayed gastric emptying was significantly higher in Feeding jejunostomy group. [p=0.021]. There was no significant difference in development of pancreatic fistula between the two group. (p=0.536). Deep surgical site infection were significantly higher in feeding jejunostomy group. (p=0.013). Hospital stay was significantly more in feeding jejunostommy group, weighted mean difference of 2.094 days. (p<0.0001). There was no significant difference between readmission (p=0.536) and TPN requirement between the two group. Time to start oral feed was significantly more in feeding jejunostomy group. Conclusion: Feeding jejunostomy seems to be associated with increased morbidity, increased complications, increased length of stay without any significant benefits.

Subject Areas

Pancreaticoduodenectomy; feeding jejunostomy; morbidity; mortality

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