A PROSPECTIVE RANDOMIZED TRIAL OF TOTAL PARENTERAL-NUTRITION AFTER MAJOR PANCREATIC RESECTION FOR MALIGNANCY

Objectives The authors examined the impact of adjuvant total parentera l nutrition after major pancreatic resection for malignancy. Summary B ackground Data Previous studies have suggested a benefit to perioperat ive nutritional support for patients undergoing major gastrointestinal surgery. Methods A prospective, randomized study was conducted using patients who had undergone a major pancreatic resection with randomiza tion on postoperative day one to either receive or not receive adjuvan t total parenteral nutrition. Results No benefit could be demonstrated by the use of adjuvant parenteral nutrition in this setting. Complica tions were significantly greater in the group receiving total parenter al nutrition. These complications tended to be those associated with i nfection. Conclusions Routine applications of postoperative parenteral nutrition to patients undergoing major pancreatic resection for malig nancy cannot be recommended. Further studies are required to determine the reason that infectious complications in these patients are increa sed.