NCT01580527

Brief Summary

Pancreaticoduodenectomy is a major surgery burdened by important morbidity and mortality partially related to the altered nutritional status of the patients. The perioperative malnutrition is a major risk factor of postoperative complications and worsens the prognosis of the patients. The perioperative artificial nutrition has for objectives to correct the preoperative malnutrition, and to maintain the nutritional status in the post-operative period. The current guidelines in surgery are in favour of a realisation of a perioperative artificial nutrition support that privilege the enteral nutrition. However, after pancreaticoduodenectomy, the total parenteral nutrition remains most usually used in the early postoperative period, although rare studies suggest a benefit of the enteral nutrition in term of reduction of the post-operative complications. Indeed, no recommendation was formulated concerning early enteral nutrition after pancreaticoduodenectomy because few studies were realized on its profits. The data of the literature report rates of complications (essentially major) from 49 % to 59 % after major digestive surgery (not only pancreatic) on patients having received a total parenteral nutrition versus rates from 34 to 43.8 % in patients having received an early enteral nutrition. A preliminary prospective study realized in the investigators centre showed a rate of 74 % complication versus 44 %, respectively in the total parenteral nutrition and early enteral nutrition groups (50 patients in every group, with p \< 0.01. All the complications were listed prospectively). Hypothesis : The early enteral nutrition will allow, after pancreaticoduodenectomy, a decrease of, at least, 19 % complications of any stage according to the classification of Dindo-Clavien (59 % versus 40 %).

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
220

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2011

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2011

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

January 31, 2012

Completed
3 months until next milestone

First Posted

Study publicly available on registry

April 19, 2012

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2014

Completed
Last Updated

April 19, 2012

Status Verified

April 1, 2012

Enrollment Period

3 years

First QC Date

January 31, 2012

Last Update Submit

April 17, 2012

Conditions

Keywords

postoperative artificial nutritionparenteral nutritionenteral nutritionpostoperative complicationscephalic pancreatoduodenectomy

Outcome Measures

Primary Outcomes (1)

  • Percentage of patients presenting one or several postoperative complications

    Data recorded during the period of hospitalization (an expected average of 3 weeks) and until control visit 3 months after surgery

    90 days

Secondary Outcomes (9)

  • Nutritional status

    90 days

  • Infectious complications

    within the hospitalization time after surgery (an expected average of 3 weeks)

  • Evaluation of the severity of the complications

    within the hospitalization time after the surgery (an expected average of 3 weeks)

  • Pancreatic fistulas

    within the hospitalization time after the surgery (an expected average of 3 weeks)

  • Hemorrhagic complications

    within the hospitalization time after the surgery (an expected average of 3 weeks)

  • +4 more secondary outcomes

Study Arms (2)

total parenteral nutrition

ACTIVE COMPARATOR
Procedure: Total parenteral nutrition

Early enteral nutrition

EXPERIMENTAL
Procedure: Enteral nutrition

Interventions

Total parenteral nutrition in postoperative of pancreaticoduodenectomy

total parenteral nutrition

Early enteral nutrition in postoperative of pancreaticoduodenectomy

Early enteral nutrition

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female patients more than 18 years of age.
  • Pancreatic surgery by pancreaticoduodenectomy.
  • Patient affiliated to a mode of the social security or receiving of such a mode.
  • Having given written informed consent prior to any procedure related to the study

You may not qualify if:

  • ASA score ≥4
  • Pregnant women
  • Patient who cannot give written informed consent.
  • Concomitant participation in a biomedical study being able to interfere with this research
  • Patient less than 18 years of age or more than 18 years of age, protected by the Law, under guardianship

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Unité de Chirurgie Hépatobiliaire et Pancréatique Hopital Edouard Herriot

Lyon, 69437, France

RECRUITING

MeSH Terms

Conditions

Pancreatic DiseasesHyperphagiaPostoperative Complications

Interventions

Parenteral Nutrition, TotalEnteral Nutrition

Condition Hierarchy (Ancestors)

Digestive System DiseasesSigns and Symptoms, DigestiveSigns and SymptomsPathological Conditions, Signs and SymptomsPathologic Processes

Intervention Hierarchy (Ancestors)

Parenteral NutritionFeeding MethodsTherapeuticsNutritional SupportNutrition Therapy

Central Study Contacts

Mustapha ADHAM, Professor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 31, 2012

First Posted

April 19, 2012

Study Start

March 1, 2011

Primary Completion

March 1, 2014

Study Completion

March 1, 2014

Last Updated

April 19, 2012

Record last verified: 2012-04

Locations