Abstract:
BACKGROUND:The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more distal enteral anastomosis after PD may further improve glycemic status. METHODS:To test the effect of distal enteral feeding on glucose metabolism in patients after PD, we performed a meal test on 20 patients via a nasogastric tube [proximal feeding group (PFG)] on post-operative day 5 and then via an intra-operatively placed jejunostomy feeding tube [distal feeding group (DFG)] on post-operative day. Blood samples were assessed for hormones and glucose. RESULTS:The AUC0-120 min levels of GLP-1, C-peptide, and insulin after distal feeding were significantly higher than after proximal feeding. The AUC0-120 min levels of glucose in the DFG were significantly lower than in the PFG. CONCLUSIONS:More distal enteral feeding contributed to better glucose metabolism after PD.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Wu JM,Yang CY,Kuo TC,Lai HS,Chiang PY,Hsieh SH,Tien YWdoi
10.1007/s00268-015-3157-7subject
Has Abstractpub_date
2015-11-01 00:00:00pages
2771-5issue
11eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3157-7journal_volume
39pub_type
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