Routine nasogastric decompression versus no decompression during pancreatoduodenectomy: Metaanalysis of perioperative outcomes

ABSTRACT NUMBER: NESTAC MEDAL FOR MEDICAL STUDENTS_4

 

AUTHOR
Thejasvin K

MAIN ABSTRACT TEXT

Introduction
There is no consensus regarding the use of nasogastric tube NGT after pancreaticoduodenectomy PD. The present meta-analysis aims to review the current evidence on the impact of routine nasogastric decompression (NGD) following PD on perioperative outcomes.

Methods
All studies indexed in PubMed, Medline, Scopus, Embase and Cochrane data bases reporting the role of gastric/nasogastric, tube/decompression after pancreatic surgery and the perioperative outcomes were retrieved and analysed up to January 2021.

Results
Eight studies with total of 1301 patients were enrolled of which 668 patients have had routine NGD, which was associated with higher incidence of delayed gastric emptying (DGE) and Clinically relevant DGE (OR = 2.51, 95% CI; 1.12 – 5.63, I2 = 83%, P = 0.03) and (OR = 3.64, 95% CI: 1.83 – 7.25, I2 = 54%, P < 0.01), respectively.
Routine NGD group had higher rate of Clavien-Dindo ≥ 2 (OR = 3.12, 95% CI: 1.05 – 9.28, I2 = 88%, P = 0.04), also longer hospital stay (OR = 3.12, 95% CI: 1.05 – 9.28, I2 = 88%, P = 0.04). However, there were no significant difference between the two groups in overall complications (OR = 1.07, 95% CI: 0.79 – 1.46, I2 0%, P = 0.66), or in POPF (OR = 1.21, 95% CI: 0.86 – 1.72, I2 = 0%, P = 0.28).

Conclusion
Omitting NGD after PD was associated with less DGE, major complications, and shorter hospital stay. Hence, routine NGT may not be necessary after PD surgery.