Effects of early oral feeding on pancreatic fistula after distal pancreatectomy

Objective To analyze the effect of early oral feeding on pancreatic fistula after distal pancreatectomy (DP). Methods A total of 189 patients who underwent distal pancreatectomy in Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2019 were enrolled and their clinical data were retrospectively analyzed. According to postoperative nutrition methods, the patients were divided into two groups: an early oral feeding (EOF) group (n=77) and a non-early oral feeding (NEOF) group (n=112). There were 41 patients with postoperative pancreatic fistula, including 17 patients in the EOF group and 24 patients in the NEOF group. Both groups were compared for the incidence of pancreatic fistula. Their extubation time of abdominal drainage tube, cumulative pancreatic fistula closure rate, abdominal drainage volume, the level of amylase in drainage fluid, and the incidence of postoperative complications were recorded. Results There was no significant difference in the incidence of pancreatic fistula between the two groups (P>0.05). There were no significant differences in extubation time, cumulative pancreatic fistula closure rate, abdominal drainage volume 1, 3, 5 and 7 days after operation, the amylase levels in drainage fluid 1-2, 3-4, 5-6, and 7-8 days after operation and postoperative complications between patients with pancreatic fistula in the two groups (P>0.05). However, patients in the EOF group presented significantly shorter length of hospitalization stay than those in the NEOP group (P<0.05). Conclusions Early oral feeding after DP does not increase the incidence and duration of pancreatic fistula, and can shorten the length of hospitalization stay of patients with pancreatic fistula.