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Distal Enteral Feeding Helps Blood Sugar Control in Pancreatectomized Patients

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Abstract

Background

The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more distal enteral anastomosis after PD may further improve glycemic status.

Methods

To test the effect of distal enteral feeding on glucose metabolism in patients after PD, we performed a meal test on 20 patients via a nasogastric tube [proximal feeding group (PFG)] on post-operative day 5 and then via an intra-operatively placed jejunostomy feeding tube [distal feeding group (DFG)] on post-operative day. Blood samples were assessed for hormones and glucose.

Results

The AUC0–120 min levels of GLP-1, C-peptide, and insulin after distal feeding were significantly higher than after proximal feeding. The AUC0–120 min levels of glucose in the DFG were significantly lower than in the PFG.

Conclusions

More distal enteral feeding contributed to better glucose metabolism after PD.

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Acknowledgments

This study was supported by grants to Y.W. T. from National Taiwan University Hospital (NCTRC201202).

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Authors and Affiliations

  1. Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc

    Jin-Ming Wu, Ching-Yao Yang, Ting-Chun Kuo, Hong-Shiee Lai & Yu-Wen Tien

  2. Department of Nursing, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Roc

    Pin-Yi Chiang & Su-Hua Hsieh

Authors
  1. Jin-Ming Wu
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  2. Ching-Yao Yang
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  3. Ting-Chun Kuo
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  4. Hong-Shiee Lai
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  5. Pin-Yi Chiang
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  6. Su-Hua Hsieh
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  7. Yu-Wen Tien
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Correspondence to Yu-Wen Tien.

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Wu, JM., Yang, CY., Kuo, TC. et al. Distal Enteral Feeding Helps Blood Sugar Control in Pancreatectomized Patients. World J Surg 39, 2771–2775 (2015). https://doi.org/10.1007/s00268-015-3157-7

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  • DOI: https://doi.org/10.1007/s00268-015-3157-7

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