Clinical Effect of Enteral Nutrition Therapy Via Nasal-Jejunum Tube and Stoma of Jejunum after Whipple Procedure_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 JIAShi-feng ¹ , YANFeng ¹ , ZHUHong-cheng ¹ , JIAOGui-mei ¹ , LIUBo ²

1. Department of Surgical Oncology, Affiliated Hospital of Hebei United University, Tangshan 063100, Hebei Province, China;
2. Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100039, China;

Corresponding?author：

JIAShi-feng, Email: jsfmmjsf@163.com

Keywords：

Whipple procedure; Jejunum stoma; Enteral nutrition

DOI：

10.7507/1007-9424.20140240

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the clinical effects of enteral nutrition via stoma of jejunum or nasal-jejunum tube after Whipple procedure. Methods Eighty-seven patients performed Whipple procedure were divided into nasaljejunum tube group(n=47)and stoma of jejunum group(n=40)according to the different enteral nutrition methods. The adverse reactions such as vomiting, abdominal distension, pharyngeal pain, and hypostatic pneumonia, anastomotic leakage, hospital stay, hospitalization expenses, and serum glucose and electrolyte(CL^-, Na⁺, K⁺)on day 1, 3, 5 after operation were compared between two groups. Results Compared with the nasal-jejunum tube group, the rates of adverse reactions and hypostatic pneumonia were more lower(P < 0.05), the hospitalization expense was more less (P < 0.05) in the nasal-jejunum tube group. The rate of anastomotic leakage and hospital stay had no significant differences between the nasal-jejunum tube group and stoma of jejunum group(P > 0.05). The differences of serum glucose and electrolyte(CL^-, Na⁺, K⁺)on day 1, 3, 5 after operation were not statistically significant between two groups(P > 0.05). Conclusions Enteral nutrition via the stoma of jejunum after Whipple procedure has some better clinical effects in reducing adverse reactions such as vomiting, abdominal distension, pharyngeal pain, hypostatic pneumonia. The hospitalization expenses are decreased. There are no obvious effects on the hospital stay, blood glucose and electrolyte concentration on day 1, 3, 5 after operation.

Citation： JIAShi-feng, YANFeng, ZHUHong-cheng, JIAOGui-mei, LIUBo. Clinical Effect of Enteral Nutrition Therapy Via Nasal-Jejunum Tube and Stoma of Jejunum after Whipple Procedure. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(8): 1001-1004. doi: 10.7507/1007-9424.20140240 Copy

1.	游華, 梁峰, 劉莎莎, 等.早期腸內營養對胃大部切除術后患者營養狀態、肝功能及并發癥的影響[J].山東醫藥, 2010, 50(20): 79-80.
2.	趙海平, 胡文秀, 呂飛飛, 等.胰腺十二指腸切除術中不同胰腸吻合術式對圍手術期并發癥的影響[J].中國普外基礎與臨床雜志, 2013, 20(7): 713-718.
3.	薛秀娟, 孫欣, 張小術, 等.胃腸道腫瘤患者圍手術期腸內營養支持的臨床研究[J].實用臨床醫藥雜志, 2007, 3(3): 1-2, 4.
4.	Zopf Y, Rabe C, Bruckmoser T, et al. Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome[J]. Digestion, 2009, 79(2): 92-97.
5.	Zschau N, Nguyen N, Tam W, et al. Intestinal perforation: a rare complication of percutaneous endoscopic jejunostomy removal[J]. Endoscopy, 2008, 40 Suppl 2: E178.
6.	史贏, 陳金明, 孟凡宇.胰十二指腸切除術后經空腸營養管行自制膳食腸內營養支持的臨床研究[J].臨床外科雜志, 2011, 19(1): 30-32.
7.	Kuwabara Y, Takeyama H. Nutritional support to prevent infectious complication after surgery[J]. Nippon Geka Gakkai Zasshi, 2010, 111(6): 348-352.
8.	Wang X, Pan L, Zhang P, et al. Enteral nutrition improves clinical outcome and shortens hospital stay after cancer surgery[J]. J Invest Surg, 2010, 23(6): 309-313.
9.	Gunerhan Y, Koksal N, Sahin UY, et al. Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters[J]. World J Gastroenterol, 2009, 15(4): 467-472.
10.	袁琮韡, 李俊生, 嵇振嶺, 等.全腸外營養及早期腸內營養在胃癌全胃切除術后患者中的對比研究[J].中國普外基礎與臨床雜志, 2010, 17(4): 357-362.
11.	臧寶華.完全胃腸外營養的臨床應用與護理研究進展[J].實用臨床醫藥雜志, 2007, 3(6): 6-9.
12.	宋康頡, 昝建寶, 汪大田, 等.全胃切除術后早期腸內腸外營養的對比研究[J].安徽衛生職業技術學院學報, 2009, 8(1): 33-34, 44.
13.	Szczepanik AM, Scis?o L, Walewska E, et al. The effect of immunomodulating enteral nutrition on postoperative cytokine profile in gastric cancer patients[J]. Pol Merkur Lekarski, 2010, 29(172): 235-240.
14.	石悅, 張佳林, 葛春林, 等.胰十二指腸切除術后不同營養支持方式營養療效的臨床分析[J].遼寧醫學雜志, 2013, 27(4): 166-170.
15.	趙玉洲, 韓廣森, 馬鵬飛, 等.胰十二指腸切除術中經胃造口管放置空腸營養管的臨床研究[J].腸外與腸內營養, 2012, 19(1): 12-15.
16.	Ogawa T, Oodaira H, Suzuki Y, et al. Successive application of percutaneous endoscopic gastrostomy with jejunal extension and percutaneous endoscopic jejunostomy in a case of multiple system atrophy[J]. Rinsho Shinkeigaku, 2009, 49(6): 370-373.
17.	Moran GW, Fisher NC. Direct percutaneous endoscopic jejunostomy: high completion rates with selective use of a long drainage access needle[J]. Diagn Ther Endosc, 2009, 2009, Article ID 520879. http://dx.doi.org/10.1155/2009/520879..
18.	高明, 強榮.全胃切除術患者經空腸造口與留置鼻空腸營養管行腸內營養比較分析響[J].中國醫師進修雜志, 2012, 35(17): 37-39.
19.	馮源, 吳楠, 陳晉峰, 等.術中經皮穿刺空腸營養管或經鼻空腸營養管置入對食管癌患者圍手術期營養支持的影響[J].中華臨床營養雜志, 2013, 21(1): 8-12.
20.	席鵬程, 時開網, 楊坤興.胰管內徑對胰十二指腸切除術后胰瘺發生率的影響[J].中國普外基礎與臨床雜志, 2009, 16(8): 609-612.
21.	劉戰培, 蒲青凡, 周勇. 233例胰十二指腸切除術后并發癥及死亡危險因素多因素分析[J].中國普外基礎與臨床雜志, 2008, 15(3): 195-200.
22.	Rayar M, Sulpice L, Meunier B, et al. Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child Reconstruction[J]. J Gastrointest Surg, 2012, 16(5): 1004-1011.
23.	呂飛飛, 趙海平.胰十二指腸切除術的早期并發癥及危險因素分析(附71例報告)[J].中國普外基礎與臨床雜志, 2008, 15(3): 205-206.

1. 游華, 梁峰, 劉莎莎, 等.早期腸內營養對胃大部切除術后患者營養狀態、肝功能及并發癥的影響[J].山東醫藥, 2010, 50(20): 79-80.
2. 趙海平, 胡文秀, 呂飛飛, 等.胰腺十二指腸切除術中不同胰腸吻合術式對圍手術期并發癥的影響[J].中國普外基礎與臨床雜志, 2013, 20(7): 713-718.
3. 薛秀娟, 孫欣, 張小術, 等.胃腸道腫瘤患者圍手術期腸內營養支持的臨床研究[J].實用臨床醫藥雜志, 2007, 3(3): 1-2, 4.
4. Zopf Y, Rabe C, Bruckmoser T, et al. Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome[J]. Digestion, 2009, 79(2): 92-97.
5. Zschau N, Nguyen N, Tam W, et al. Intestinal perforation: a rare complication of percutaneous endoscopic jejunostomy removal[J]. Endoscopy, 2008, 40 Suppl 2: E178.
6. 史贏, 陳金明, 孟凡宇.胰十二指腸切除術后經空腸營養管行自制膳食腸內營養支持的臨床研究[J].臨床外科雜志, 2011, 19(1): 30-32.
7. Kuwabara Y, Takeyama H. Nutritional support to prevent infectious complication after surgery[J]. Nippon Geka Gakkai Zasshi, 2010, 111(6): 348-352.
8. Wang X, Pan L, Zhang P, et al. Enteral nutrition improves clinical outcome and shortens hospital stay after cancer surgery[J]. J Invest Surg, 2010, 23(6): 309-313.
9. Gunerhan Y, Koksal N, Sahin UY, et al. Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters[J]. World J Gastroenterol, 2009, 15(4): 467-472.
10. 袁琮韡, 李俊生, 嵇振嶺, 等.全腸外營養及早期腸內營養在胃癌全胃切除術后患者中的對比研究[J].中國普外基礎與臨床雜志, 2010, 17(4): 357-362.
11. 臧寶華.完全胃腸外營養的臨床應用與護理研究進展[J].實用臨床醫藥雜志, 2007, 3(6): 6-9.
12. 宋康頡, 昝建寶, 汪大田, 等.全胃切除術后早期腸內腸外營養的對比研究[J].安徽衛生職業技術學院學報, 2009, 8(1): 33-34, 44.
13. Szczepanik AM, Scis?o L, Walewska E, et al. The effect of immunomodulating enteral nutrition on postoperative cytokine profile in gastric cancer patients[J]. Pol Merkur Lekarski, 2010, 29(172): 235-240.
14. 石悅, 張佳林, 葛春林, 等.胰十二指腸切除術后不同營養支持方式營養療效的臨床分析[J].遼寧醫學雜志, 2013, 27(4): 166-170.
15. 趙玉洲, 韓廣森, 馬鵬飛, 等.胰十二指腸切除術中經胃造口管放置空腸營養管的臨床研究[J].腸外與腸內營養, 2012, 19(1): 12-15.
16. Ogawa T, Oodaira H, Suzuki Y, et al. Successive application of percutaneous endoscopic gastrostomy with jejunal extension and percutaneous endoscopic jejunostomy in a case of multiple system atrophy[J]. Rinsho Shinkeigaku, 2009, 49(6): 370-373.
17. Moran GW, Fisher NC. Direct percutaneous endoscopic jejunostomy: high completion rates with selective use of a long drainage access needle[J]. Diagn Ther Endosc, 2009, 2009, Article ID 520879. http://dx.doi.org/10.1155/2009/520879..
18. 高明, 強榮.全胃切除術患者經空腸造口與留置鼻空腸營養管行腸內營養比較分析響[J].中國醫師進修雜志, 2012, 35(17): 37-39.
19. 馮源, 吳楠, 陳晉峰, 等.術中經皮穿刺空腸營養管或經鼻空腸營養管置入對食管癌患者圍手術期營養支持的影響[J].中華臨床營養雜志, 2013, 21(1): 8-12.
20. 席鵬程, 時開網, 楊坤興.胰管內徑對胰十二指腸切除術后胰瘺發生率的影響[J].中國普外基礎與臨床雜志, 2009, 16(8): 609-612.
21. 劉戰培, 蒲青凡, 周勇. 233例胰十二指腸切除術后并發癥及死亡危險因素多因素分析[J].中國普外基礎與臨床雜志, 2008, 15(3): 195-200.
22. Rayar M, Sulpice L, Meunier B, et al. Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child Reconstruction[J]. J Gastrointest Surg, 2012, 16(5): 1004-1011.
23. 呂飛飛, 趙海平.胰十二指腸切除術的早期并發癥及危險因素分析(附71例報告)[J].中國普外基礎與臨床雜志, 2008, 15(3): 205-206.

Next Article
Diagnosis and Treatment of Postoperative Intestinal Obstruction of Gastrointestinal Cancer

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Effect of Enteral Nutrition Therapy Via Nasal-Jejunum Tube and Stoma of Jejunum after Whipple Procedure

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content