Impact of the Absence of Nasogastric Decompression After Pancreaticoduodenectomy

The use of nasogastric (NG) decompression after pancreaticoduodenectomy (PD) is a current practice. NG tube is associated with a high rate of morbidity including pulmonary morbidity, delayed gastric emptying and finally an increased length of hospital stay. In the era of the enhance recovery after major abdominal surgery, the place of the NG tube remains unproven after PD even if NG tube is clearly abandoned in liver, stomach and colonic surgery. Nowadays, only few retrospective series had reported the feasibility of the absence of nasogastric tube after PD, but not with a randomized control trial. The absence of NG decompression could be the corner stone of the concept of the enhanced recovery program after PD.

The objective of this prospective randomized monocentric study is to evaluate the impact of the absence of NG decompression after PD.

The aim of the study is to decrease postoperative morbidity after PD including pulmonary and delayed gastric emptying complication. The impact of the absence of systematic NG decompression could be interesting in terms of public health with a decreased of length of hospital stay. Furthermore, this is the first randomized study comparing NG tube decompression after PD to absence of NG tube after PD which would bring relevant elements to improve the recovery after PD.

Inclusion criteria

• Age > 18 years and ≤ 75 years
• patient requiring a PD for benign of malign pathology of the bilio and pancreatic intersection
• patient giving free and informed consent

Exclusion criteria

• previous gastric of esophagus surgery
• sever comorbidity such as : end stage renal disease, respiratory failure, heart failure (≥ 3 NYHA)
• Person with a measure of legal protection (guardianship)
• Pregnant woman or nursing mother