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EARLY VS CONVENTIONAL ORAL FEEDING AFTER PANCREATICODUODENECTOMY: A PROSPECTIVE OBSERVATIONAL STUDY
AJAY SHARMA, VNAY KUMAR MAHALA, ANAND NAGAR, SHASHWAT SARN, HARSHL SHAH, MLND AKHAN, HRSHKESH SNHASANE, RAJENDRA PRASAD CHOUBEY, PEEYUSH VARSHNEY
Euroasian Journal of Hepato-Gastroenterology - 2025;15(1):29-33

Background: Enhanced recovery after surgery (ERAS) protocols following pancreaticoduodenectomy (PD) have shown promising results. In all previous studies on ERAS following PD; the earliest oral feeding (liquids only) was started on the first postoperative day; our objective was to start oral (liquid and soft) feed at 6 hours of surgery and assess its effect on postoperative outcome. Materials and methods: All 26 patients (Group-I) undergoing PD from November 2021 to June 2022 were prospectively enrolled and subjected to early oral feeding (EOF), i.e., oral feed at 6 hours. They were compared with a retrospective cohort (Group-II) of 40 patients who received conventional oral feeding (COF) i.e., by feeding jejunostomy on day 1. Results: Age, intraoperative blood loss, and operative time were comparable. Time to start oral liquid (0 vs 1.5 1.2 days, p = 0.00), soft diet (0 vs 3.8 1.9 days, p = 0.00) and solid diet (3.1 0.5 vs 7.2 2.9 days, p = 0.00) was significantly shorter in EOF group. Nasogastric (NG) tube removal was earlier (1.6 1.5 vs 3.9 1.7 days, p 0.00) and required reinsertion less frequently in the EOF group. First stool passage time (3.7 0.9 vs 5.9 1.8 days, p 0.00) and stoppage of intravenous fluids (3.4 0.8 vs 5.2 1.8 days, p 0.00) were significantly earlier in EOF group. The length of postoperative hospital stay was less (5.9 2.6 vs 8.8 4.1 days, p 0.007) in the EOF group. There was no significant difference in postoperative complications, 90-day mortality, and readmission rates between the two groups. Conclusion: Early oral feeding after PD is feasible, safe, and reduces hospital stay.

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