Effect of early enteral eco-immunonutrition therapy on patients after pancreaticoduodenectomy

Abstract:

Objective To investigate the effect of early enteral eco-immunonutrition therapy on the nutritional status，postoperative complication，and immune function of patients after pancreatoduodenectomy.Methods A total of 190 patients who underwent pancreatoduodenectomy in Department of Geriatric Surgery，The First Affiliated Hospital of Xi’an Jiaotong University，from January 2019 to December 2022 were enrolled according to the inclusion criteria，and they were randomly divided into study group and control group using the method of simple random grouping in Excel. All 190 patients completed the study，with 95 patients in the study group and 95 patients in the control group. The patients in the study group received individualized enteral eco-immunonutrition therapy since day 1 after surgery，and those in the control group were given conventional nutrition，mainly parenteral nutrition. Related indices were measured before surgery and on days 3，7，10，and 14 after surgery，including serum albumin，pre albumin，urea，creatinine，hemoglobin，total cholesterol，and lymphocyte count（percentage），and the two groups were observed in terms of the amount of red cell suspension and plasma used during surgery，duration of postoperative ventilation，length of hospital stay，drug and in-hospital expenditure，and the total percentage of drug expenditure in hospital. Postoperative complications and the differences in the above indicators were analyzed for the two groups，and a generalized linear regression analysis was used to investigate the factors associated with complications.Results There was a significant difference in the incidence rate of postoperative complications between the study group and the control group［15 cases（15.79%） vs. 36 cases（37.89%），χ²=12.095，P=0.001）. Compared with the control group，the study group had a significantly higher serum albumin level on days 7 and 10 after surgery，a significantly higher serum prealbumin level on days 7，10，and 14 after surgery，a significantly higher lymphocyte count on days 10 and 14 after surgery，a significantly higher percentage of lymphocytes on days 7，10，and 14 after surgery，a significantly higher hemoglobin level on days 3，10，and 14 after surgery，and a significantly higher serum level of total cholesterol on day 10 after surgery（all P<0.05）. The generalized linear regression analysis showed that postoperative complications were positively correlated with female sex，body mass index，international nutrition score，viral hepatitis，length of postoperative ventilation，and amount of plasma transfusion，while postoperative complications were negatively correlated with nutritional therapy.Conclusion Early enteral eco-immunonutrition therapy for patients after pancreatoduodenectomy can significantly improve their nutritional status，reduce the incidence rate of postoperative complications，and enhance their immune function.