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Routine Nasogastric Decompression Is Unnecessary After Pancreatic Resections

Christina L. Roland, MD; John C. Mansour, MD; Roderich E. Schwarz, MD, PhD
Arch Surg. 2012;147(3):287-289. doi:10.1001/archsurg.2011.1260.
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Data regarding the use of nasogastric tubes (NGTs) in patients who are undergoing pancreatic resections are limited. We analyzed outcomes after 231 consecutive pancreatectomy procedures in an academic surgical oncology practice. We routinely placed NGTs intraoperatively throughout the first part of the study interval; orogastric tubes (OGTs) were removed intraoperatively before endotracheal extubation whenever possible in the second part of the study (n = 75 [32%]). The median postoperative NGT duration was 1 day (OGT group, 0 days; NGT group, 2 days [P < .001]). Reinsertion of the NGT was necessary in 43 patients (19%) and did not differ between patients after routine NGT or OGT use (19% vs 19%). Nasogastric tubes were reinserted after 74% of major complications compared with 29% of minor complications (P < .001). Our experience demonstrates that the use of NGTs can be safely avoided in patients who are undergoing pancreatectomies.

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Figure 1. Intraoperative nasogastric tube (NGT) insertion is associated with prolonged NGT duration. A, Cumulative NGT duration, by tube status. B, Hospital stay with NGT in place. Error bars indicate 95% CIs.

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Figure 2. Nasogastric tube (NGT) reinsertion and associations with hospital stay and morbidity. A, Frequency of NGT reinsertion. B, Cumulative hospital stay by NGT reinsertion. C, Frequency of NGT reinsertion, by postoperative morbidity. The P value reflects the differences between major and minor complication groups.

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