Photo Credit: Rasi Bhadramani

The following is a summary of “Impact of perioperative immunonutrition on postoperative outcomes in pancreaticoduodenectomy: a systematic review and meta-analysis of randomized controlled trials,” published in the November 2024 issue of Gastroenterology by Zhang et al.  

The effectiveness of perioperative immunonutrition in enhancing recovery and reducing complications after pancreaticoduodenectomy (PD) remains an area of ongoing study.  

Researchers conducted a retrospective study investigating the effects of perioperative immunonutrition on postoperative outcomes in patients undergoing PD.  

They searched PubMed, Embase, Cochrane Library, Medline, and Web of Science databases for RCTs on immunonutrition and PD. Data extraction, bias risk assessment, and meta-analysis were done using RevMan 5.3 software.  

The results showed 10 RCTs with 574 patients, 288 in the immunonutrition group, and 283 in the control group. Perioperative immunonutrition was associated with significantly fewer postoperative infection-related complications (OR = 0.45; 95% CI: 0.27–0.74; P=0.002) and severe postoperative complications (OR = 0.61; 95% CI: 0.38–0.98; P=0.04). Additionally, the immunonutrition group had a significantly shorter length of hospital stay (mean difference [MD] = -1.87; 95% CI: -3.29 to -0.44; P=0.01). No statistically notable difference in the overall complication rate between the 2 groups (P=0.67). The incidence of specific complications and perioperative mortality rates also did not show statistically significant differences (all P>0.05).  

They concluded that perioperative immunonutrition reduced postoperative infection-related complications in patients with PD, but further high-quality RCTs were needed for confirmation.  

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03510-6