A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy

Objectives: The authors examined the impact of adjuvant total parenteral nutrition after major pancreatic resection for malignancy. Summary Background Data: Previous studies have suggested a benefit to perioperative nutritional support for patients undergoing major gastrointestinal surgery. Methods: A prospective, randomized study was conducted using patients who had undergone a major pancreatic resection with randomization on postoperative day one to either receive or not receive adjuvant total parenteral nutrition. Results: No benefit could be demonstrated by the use of adjuvant parenteral nutrition in this setting. Complications were significantly greater in the group receiving total parenteral nutrition. These complications tended to be those associated with infection. Conclusions: Routine applications of postoperative parenteral nutrition to patients undergoing major pancreatic resection for malignancy cannot be recommended. Further studies are required to determine the reason that infectious complications in these patients are increased.