Little Benefit of Routine Total Parenteral Nutrition after Pancreatoduodenectomy

Objective: The role of Total Parenteral Nutrition (TPN) in the management of patients undergoing major pancreas resection remains controversial, and this study evaluated the impact of perioperative TPN after pancreatoduodenectomy. Methods: A retrospective case control study was conducted using nourished patients who had undergone pancreatoduodenectomy in the previous six years grouped under those who received (TPN group, N=55) or did not receive perioperative TPN (control group, N=54). Postoperative morbidity, mortality, length of hospital stay were reviewed in all patients. Results: The overall morbidity rate was similar (54.5% for TPN vs. 44.4% for control). No difference was detected for either infectious (40.0% vs. 24%) or noninfectious complications (34.5% vs. 31.5%), major complications (16.3% vs. 5.6%) or mortality (5.5% vs. 0%). The length of hospital stay was similar.(median 31 days vs. 30 days). Conclusion: Although this study was examined retrospectively, it was not demonstrated that the routine application of perioperative TPN in the nourished patients secure pancreatoduodenectomy. TPN might be indicated for malnourished or patients with postoperative complications.