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Nasogastric Decompression Following Pancreaticoduodenectomy


2018-06-01


2023-05-31


2023-12-31


230

Study Overview

Nasogastric Decompression Following Pancreaticoduodenectomy

Pancreaticoduodenectomy (PD) remains the gold-standard operation for peri-ampullary neoplasms. Traditionally, gastric decompression via nasogastric intubation has been employed postoperatively to prevent nausea, vomiting, aspiration pneumonia, anastomotic leakage and delayed gastric emptying. Recently, the implementation of ERAS protocol recommended against routine use of nasogastric tube following PD. however, limited data exists surrounding the identification of those patients needing NGT decompression in the immediate postoperative period. Therefore, we initiated a large prospective randomized controlled trial to evaluate the clinical outcomes of patients who retained the NGT post-PD versus those who had it removed at the end of the procedure. This study aims to assess the effectiveness of nasogastric decompression in PD recovery, with the primary endo point being the need for and impact of NGT in the postoperative recovery. The secondary endpoint will examined the re-insertion rate of NGT and identify factors that necessitate its use in the immediate postoperative period.

N/A

  • Pancreatic Head Neoplasm
  • Delayed Gastric Emptying
  • Post Operative Ileus
  • Whipple Procedure
  • PROCEDURE: pancreaticoduodenectomy
  • H-43383

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2024-05-07  

N/A  

2024-05-10  

2024-05-10  

N/A  

2024-05-14  

2024-05-14  

N/A  

2024-05  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment


Allocation:
Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
ACTIVE_COMPARATOR: Group A ( No NGT)

PROCEDURE: pancreaticoduodenectomy

  • Surgical removal of the head of the pancreas, duodenum, extrahepatic bile duct, distal stomach, and proximal jejunum. Group A cohort will not have NGT placed in the postoperative period. Whereas, group B will have the NGT retained in the posoperative peri
ACTIVE_COMPARATOR: Group B (NGT Retained)

PROCEDURE: pancreaticoduodenectomy

  • Surgical removal of the head of the pancreas, duodenum, extrahepatic bile duct, distal stomach, and proximal jejunum. Group A cohort will not have NGT placed in the postoperative period. Whereas, group B will have the NGT retained in the posoperative peri
Primary Outcome MeasuresMeasure DescriptionTime Frame
to assess whether nasogastric decompression following a whipple procedure will reduce the incidence and severity of postoperative complicationsSeverity of post operative complications was graded according to the Clavien-Dindo classification system adopted for pancreaic surgery, which relies on the type of treatment used for each complication with scores range from 1-4, and any complication graded >2 considered a major complication.30-days postoperatively
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Examined the re-insertion rate of Nasogastric tube following pancreaticoduodenectomyPatient will be considered to undergo nasogastric decompression with nasogastric tube if he/she demonstrated clinical evidence of postoperative ileus and delayed gastric emptying as defined according to the consensus definition proposed by the international study group of pancreatic surgery (ISGPS), the severity of which was classified into 3 grades (A,B, and C) based on clinical course and postoperative management such as the need nausea and vomiting and inability to tolerate solid oral intake by the end of the first postoperative week.30- days postoperatively
identify factors that necessitated its use in the immediate postoperative periodTo identify preoperative factors such as obesity with BMI 30 or more, Preoperative uncontrolled diabtes, older age (over 70), gender (male/female), histroy of gastric outlet obstruction, primary diagnosis (malignant disease vs benign). Intra-operative factor such such as the length of the procedure, blood loss, any concurrent procedure such as extensive lysis of adhesions, colon resection; and postoperative factors including postoperative blood counts, phosphorus and magnesium levels, blood sugar level, and postoperative complications. These factors will be assessed using logistic regression analysis to predict the necessity of nasogastric decompression in the postoperative period following the whipple procedure.30 days postoperatively

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • All patients 18 years of age or older
  • Patients undergoing successful pancreaticoduodenectomy for benign or malignant neoplasm.

  • Exclusion Criteria:

  • Patients who does not complete the procedure due to locally advanced or metastatic disease discovered during the procedure.
  • Patient who requires prolong postoperative intubation in the postoperative period.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • PRINCIPAL_INVESTIGATOR: Omar Barakat, MD, Baylor College of Medicine

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    No publications available