Avoiding nasogastric decompression safe after pancreaticoduodenectomy: JAMA

France: Avoiding nasogastric tube decompression (NGTD) after pancreaticoduodenectomy (PD) is safe, suggests a recent study in the journal JAMA Surgery. According to the study, there were no significant differences in the postoperative complications in patients subjected to systematic NGTD and no NGTD after PD. 

Standardization of PD although has improved postoperative outcomes but morbidity remains high.  Avoiding NGTD that is already outdated in major abdominal surgery is suggested after PD by fast track surgery programs. But there is a lack of high-level evidence, especially in regard to its safety.

Damien Bergeat, University of Rennes, Rennes, France, and colleagues assessed whether the absence of systematic NGTD after PD reduces postoperative complications, in a randomized clinical trial.

The IPOD study (Impact of the Absence of Nasogastric Decompression After Pancreaticoduodenectomy) was an open-label, prospective, single-center, randomized clinical trial. This was conducted at a high-volume pancreatic surgery university hospital in France. The researchers screened a total of 155 patients aged 18 to 75 years and required PD for benign or malignant disease. Key exclusion criteria were previous gastric or esophageal surgery and severe comorbidities.