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Background <p>The role of feeding jejunostomy (FJ) in recovery after pancreaticoduodenectomy (PD) remains unclear due to conflicting evidence and selection bias. This study objectively assesses the clinical impact of FJ on postoperative outcomes using the Comprehensive Complication Index (CCI) as a measure of overall morbidity.</p> Methods <p>A retrospective observational cohort study was conducted on patients undergoing classical PD between January 2018 and December 2024 .Patients were categorized based on the use of FJ. Propensity-score matching (1:1) was applied to balance baseline demographic and operative variables. Postoperative outcomes, including overall morbidity measured by the CCI and procedure-specific complications, were compared between the matched cohorts.</p> Results <p>Of 198 patients who underwent PD, 75 received a FJ and 123 did not. After 1:1 propensity-score matching, 124 patients (62 per group) were analyzed. The incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) was similar (41.9% vs. 45.1%, <i>p</i> = 0.238), whereas delayed gastric emptying occurred more frequently in the FJ group (88.7% vs. 58.0%, <i>p</i> = 0.02). Other complications and mean CCI scores did not differ significantly. Among patients with CR-POPF, FJ was associated with shorter fistula duration (4.0 ± 0.9 vs. 5.0 ± 1.6 weeks, <i>p</i> = 0.004) and reduced hospital stay (14.0 ± 4.9 vs. 15.8 ± 7.4 days, <i>p</i> = 0.028), without differences in reoperation, readmission, or mortality.</p> Conclusion <p>Routine FJ during PD does not confer an overall reduction in postoperative morbidity; however, in patients with CR-POPF, it facilitates faster fistula resolution and recovery, indicating a selective approach.</p>

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Impact of Feeding Jejunostomy on Postoperative Outcomes After Whipple’s Procedure: A Comparative Propensity Score Analysis Using the Comprehensive Complication Index

  • 期刊论文

  • 发表日期：

    2026年7月28日

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  • Rohith Kodali,
  • Utpal Anand,
  • Kunal Parasar,
  • Rajeev Nayan Priyadarshi,
  • Ramesh Kumar,
  • Basant Narayan Singh,
  • Kislay Kant,
  • Abhishek Arora

摘要

Background

The role of feeding jejunostomy (FJ) in recovery after pancreaticoduodenectomy (PD) remains unclear due to conflicting evidence and selection bias. This study objectively assesses the clinical impact of FJ on postoperative outcomes using the Comprehensive Complication Index (CCI) as a measure of overall morbidity.

Methods

A retrospective observational cohort study was conducted on patients undergoing classical PD between January 2018 and December 2024 .Patients were categorized based on the use of FJ. Propensity-score matching (1:1) was applied to balance baseline demographic and operative variables. Postoperative outcomes, including overall morbidity measured by the CCI and procedure-specific complications, were compared between the matched cohorts.

Results

Of 198 patients who underwent PD, 75 received a FJ and 123 did not. After 1:1 propensity-score matching, 124 patients (62 per group) were analyzed. The incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) was similar (41.9% vs. 45.1%, p = 0.238), whereas delayed gastric emptying occurred more frequently in the FJ group (88.7% vs. 58.0%, p = 0.02). Other complications and mean CCI scores did not differ significantly. Among patients with CR-POPF, FJ was associated with shorter fistula duration (4.0 ± 0.9 vs. 5.0 ± 1.6 weeks, p = 0.004) and reduced hospital stay (14.0 ± 4.9 vs. 15.8 ± 7.4 days, p = 0.028), without differences in reoperation, readmission, or mortality.

Conclusion

Routine FJ during PD does not confer an overall reduction in postoperative morbidity; however, in patients with CR-POPF, it facilitates faster fistula resolution and recovery, indicating a selective approach.