International Journal of Clinical Pharmacy

, Volume 37, Issue 4, pp 579–582 | Cite as

Evaluation of parenteral nutrition use in patients undergoing major upper gastro-intestinal surgery

  • Barbara DeleenheerEmail author
  • Peter Declercq
  • Hans Van Veer
  • Philippe Nafteux
  • Isabel Spriet
Short Research Report


Background After major upper gastro-intestinal surgery, enteral feeding is often hampered. There is still no consensus on which route of nutrition is preferable in patients undergoing this type of surgery. Current ESPEN guidelines recommend parenteral nutrition in undernourished patients, if caloric requirements cannot be met orally/enterally within 7 days and enteral nutrition is contraindicated. Objective The current practice of systematic parenteral nutrition at the thoracic surgery ward of the University Hospitals Leuven was evaluated based on the ESPEN guidelines. Method This prospective observational study included patients undergoing upper gastro-intestinal surgery and receiving postoperative parenteral nutrition. Parenteral nutrition use was considered appropriate when patients were undernourished and unable to obtain adequate caloric requirements by oral or enteral feeding within 7 days. Results Twenty-five out of 35 patients were nutritionally at risk. In 9 of 25 patients, the indication for parenteral nutrition was considered justified. As the intestinal tract below the anastomosis site remains accessible in the total studied population, enteral nutrition might be an option. Unfortunately, an appropriate jejunostomy tube was not available at our institution. Conclusion In accordance to the ESPEN guidelines, enteral nutrition can replace parenteral nutrition in most thoracic surgery patients, but only if an appropriate enteral access is available.


Enteral nutrition Gastro-intestinal surgery Nutrition Nutritional risk score Parenteral nutrition 



No special funding was received for this study.

Conflicts of interest

None of the authors have financial or personal relationships with other people or organizations that could inappropriately influence (bias) their work.


  1. 1.
    Alivizatos V, Gavala V, Alexopoulos P, Apostolopoulos A, Bajrucevic S. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition. Indian J Palliat Care. 2012;18(1):31–3.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Tapia J, Murguia R, Garcia G, de los Monterols PE, Oñate E. Jejunostomy: techniques, indications, and complications. World J Surg. 1999;23(6):596–602.PubMedCrossRefGoogle Scholar
  3. 3.
    Seike J, Tangoku A, Yuasa Y, Okitsu H, Kawakami Y, Sumitomo M. The effect of nutritional support on the immune function in the acute postoperative period after oesophageal cancer surgery: total parenteral nutrition versus enteral nutrition. J Med Invest. 2011;58(1–2):75–80.PubMedCrossRefGoogle Scholar
  4. 4.
    Xiao-Bo Y, Qiang L, Xiong Q, Zheng R, Jian Z, Jian-Hua Z, et al. Efficacy of early postoperative enteral nutrition in supporting patients after esophagectomy. Minerva Chir. 2014;69(1):37–46.PubMedGoogle Scholar
  5. 5.
    Fujita T, Daiko H, Nishimura M. Early enteral nutrition reduces the rate of life-threatening complications after thoracic oesophagectomy in patients with oesophageal cancer. Eur Surg Res. 2012;48(2):79–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A, Bozzetti F. ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr. 2009;28(4):378–86.PubMedCrossRefGoogle Scholar
  7. 7.
    Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Ad hoc Espen Working Group 1. Nutritional risk screening (NRS-2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321–36.PubMedCrossRefGoogle Scholar
  8. 8.
    Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25(2):224–44.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Barbara Deleenheer
    • 1
    Email author
  • Peter Declercq
    • 1
  • Hans Van Veer
    • 1
  • Philippe Nafteux
    • 1
  • Isabel Spriet
    • 1
  1. 1.University Hospitals LeuvenLouvainBelgium

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