Original Article
Effect of enteral nutrition via a naso-gastric(intestinal) tube vs a percutaneous endoscopic gastrostomy/jejunostomy tube in patients after liver transplantation: a Meta analysis
Lu Huapeng, Xiao Qigui, Wang Jing, Yang Qinling, Zheng Xin, Liu Peipei, Li Jin
Published 2018-11-28
Cite as Chin J Hepatobiliary Surg, 2018,24(11): 751-756. DOI: 10.3760/cma.j.issn.1007-8118.2018.11.006
Abstract
ObjectiveTo systematically review the effect of enteral nutrition via a naso-gastric (intestinal) tube (NG) vs a percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) after liver transplantation, and provide support for the selection of proper nutrition.
MethodsPub Med, web of science, Cochrane Library (Jan, 2018), CNKI, VIP and Wanfang Date were search until Jan, 2018. Two authors independently assessed the trials for inclusion and extracted the data. Discrepancies were resolved in consultation with a third reviewer, about the research of retrospective study for the effects of enteral nutrition via NG vs PEG/PEJ after liver transplantation was performed and supplemented. Publication bias were evaluated, and Meta-analyses were conducted with RevMan5.3.
Results4 studies were collected, involving 430 patients. The Meta-analysis showed that starting time of enteral nutrition of PEG/PEJ was earlier than NG (MD=-1.77, 95%CI -1.83 to -1.70, P<0.05). The average hospitalization time of PEG/PEJ was shorter than NG (MD=-2.88, 95%CI -5.19 to -0.56, P<0.05). The diarrhea incidence of PEG/PEJ was higher than NG (OR=1.66, 95%CI 1.04 to 2.65, P<0.05), and gastroesophageal reflux incidence of PEG/PEJ was lower than NG (OR=0.29, 95%CI 0.12 to 0.66, P<0.05). The gastric retention rate of PEG/PEJ was lower than NG (OR=0.26, 95%CI 0.14 to 0.41, P<0.05). Dislocation incidence of PEG/PEJ was lower than NG (OR=0.06, 95%CI 0.01 to 0.46, P<0.05). The pneumonia incidence of PEG/PEJ tube was lower than NG (OR=0.59, 95%CI 0.36 to 0.99, P<0.05). There were no significant differences between PEG/PEJ and NG on indwelling time, occlusion, abdominal infection, acute renal insufficiency, and acute rejection reaction.
ConclusionPEG/PEJ had earlier starting time of enteral nutrition, shorter hospitalization time, lower nutrition tube placement related complications such as gastric esophagus reflux, gastric retention, dislocation rate and lower incidence of pneumonia, but the incidence of diarrhea was higher. NG is the first choice after liver transplantation, and for patients with serious basic diseases, weak digestive function or digestive system disorders PEG/PEJ can be chosen.
Key words:
Liver transplantation; Enteral nutrition; Naso-gastric (intestinal) tube; Percutaneous endoscopic gastrostomy/jejunostomy; Meta analysis
Contributor Information
Lu Huapeng
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China
Xiao Qigui
Wang Jing
Yang Qinling
Zheng Xin
Liu Peipei
Li Jin
