ABSTRACT NUMBER: NESTAC MEDAL FOR MEDICAL STUDENTS_4
MAIN ABSTRACT TEXT
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.
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.
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).
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.