Introduction : This study is undertaken to see the effect of early starting of enteral feeding after pancreatoduodenectomy (PD). .

Methods : Thirty patients who underwent PD in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2016 to December 2016 was included in the study. They were divided into two groups; Group I (n=15): Enteral feeding was started from 2nd POD through nasojejunal feeding tube along with parenteral partial nutrition support. Group II (n=15): No enteral feeding was given up to 7-8 PODs except partial perenteral feeding. Post-operatively, serum albumin levels, total lymphocyte count, total bilirubin levels, serum alkaline phosphate levels were measured for 2 weeks postoperatively in all patients for assessing nutritional, immunological and cholestasis. Mortality, morbidity and lengths of post-operative hospital stay were also recorded.

Results : Both groups matched the same status pre- and per-operatively. Postoperatively serum albumin level and lymphocyte count decreased from preoperative level on 3rd POD and gradually increased from 7th POD onward in both groups but they remained persistently higher in Group I than Group II. Total bilirubin and alkaline phosphatase decreased to normal within 7 POD in Group I, but they remained still higher than normal level on POD 14 Group II. Morbidity and hospital stay is significantly lower in group I than group II.

Conclusions : Early enteral feeding should be considered after PD. It will improve nutritional, immunological status and cholestasis. Thus it reduces morbidity and shortens the hospital stay.