Comparing Early Enteral Nutrition Versus Parenteral Nutrition After Pancreaticoduodenectomy

Study Overview
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Brief Summary
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To prove that early enteral nutrition after pancreaticoduodenal operation is of great significance to improve the immune response, reduce the incidence of postoperative infection and other related complications, and shorten the length of hospital stay

Detailed Description
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Arm A: Total parenteral nutrition. TPN also started from POD 1 and was delivered through a central venous catheter. Target energy of 1.5 amino acids/kg/day reached 30 kcal/kg/day. Arm B: NJEEN was defined as providing at least 50% of the nutritional requirements through the nasojejunal tube prior to the 5th day after surgery (POD) and having no parenteral nutrition for 72 h or more.

Official Title
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A Prospective RCT Study of Comparing Early Enteral Nutrition Versus Parenteral Nutrition After Pancreaticoduodenectomy

Conditions
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Enteral Nutrition

Intervention / Treatment
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* Dietary Supplement: Total parenteral nutrition
* Dietary Supplement: Enteral nutrition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 80 years old, gender is not limited; All patients underwent pancreaticoduodenectomy; ECOG 0   2 for physical condition score; Imaging examination found pancreatic head, periampullary space, no distant metastasis and ascites; No bone marrow dysfunction; Those without obvious surgical contraindications; Expected postoperative survival ≥3 months; The study visit plan and other programme requirements are now available; Voluntary participation and signing of informed consent. Exclusion Criteria: Patients with stage II and IV periampullary carcinoma of head of pancreas and periampullary carcinoma; Active infected persons; Distant metastasis or ascites were found in imaging examination; Patients with serious impairment of heart, liver and kidney function (grade 3 to 4, ALT and/or AST more than 3 times the normal upper limit, Cr more than the normal upper limit); patients with other malignant tumors or blood diseases; Pregnancy, planned pregnancy and lactation female patients (urine HCG >02500 iu /L, diagnosed as early pregnancy);

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Arm A: Total parenteral nutrition<br>Total parenteral nutrition, TPN also starts from POD 1 and is delivered through a central venous catheter, with a target energy of 1.5 amino acids/kg/day reaching 30 kcal/kg/day | Dietary Supplement: Total parenteral nutrition<br>* Total parenteral nutrition, TPN also starts from POD 1 and is delivered through a central venous catheter, with a target energy of 1.5 amino acids/kg/day reaching 30 kcal/kg/day<br>|
| Experimental: Arm B: Enteral nutrition<br>NJEEN was defined as providing at least 50% of the nutritional requirements through the nasojejunal tube prior to the 5th day after surgery (POD) and having no parenteral nutrition for 72 hours or more. | Dietary Supplement: Enteral nutrition<br>* NJEEN was defined as providing at least 50% of the nutritional requirements through the nasojejunal tube prior to the 5th day after surgery (POD) and having no parenteral nutrition for 72 hours or more.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The percentage of patients with one or more postoperative complications (time range: 90 days) was observed, and data were recorded during the hospital stay (expected average of 3 weeks) and during control visits 3 months postoperatively. | The percentage of patients with one or more postoperative complications (time range: 90 days) was observed, and data were recorded during the hospital stay (expected average of 3 weeks) and during control visits 3 months postoperatively. | 3month |