Mike Montemarano, Associate Editor 03.02.21
According to a new clinical trial published in the European Review for Medical and Pharmacological Sciences, supplementation with a probiotic called Lactobacillus rhamnosus GG improved patients’ recoveries from a surgery called pancreatoduodenectomy (PPPD), a surgery which, like its name, is very complex and difficult to recover from, and has high complication rates including infections, digestive issues, and more.
The surgery itself is a major abdominal procedure, involving removing the first and second portions of the duodenum, removing the distal segment of the stomach, the head of the pancreas, the gallbladder, and common duct. To date, evidence supporting the effect of probiotics supplementation in major abdominal surgeries is limited, and even further limitations are present in surgeries involving the pancreas.
The clinical trial enrolled 40 patients undergoing PPPD, who were randomized into two groups, with a control group receiving standard nutrition, and another group of 20 participants treated with Lactobacillus rhamnosus GG in a 30-day period immediately following surgery.
Each group was monitored for gastrointestinal motility, infection complications, length of hospital stay, and mortality, and the results were compared at 14 days and 30 days after treatment. While there were no significant differences in the mortality and infectious complications between the two groups, the probiotic group’s hospital stay duration was two days shorter than that of the control group (8 vs. 10 days, respectively). Additionally, certain measures showed that the probiotic supported digestive recovery, with an earlier recurrence of postoperative bowel movements, averaging at 2.15 days for the probiotic group compared to 3.75 days for the control group, passing gasses (2.9 days vs. 4 days for the control group), and first postoperative stool (3.85 days vs. 5.84 days for the control group).
Subjectively, those who were administered probiotics also reported better appetites on postoperative day 1, 3, 5, 7, and 30 days after surgery.
“To our knowledge, this is the first study investigating the influence of single specimen probiotic containing L. rhamnosus GG strain on early post-operative outcomes after PPPD,” the authors of the study concluded. “Delayed gastric emptying is one of the most frequent complications in the early period after PPPD prolonging hospital stay, as well as impairing patients’ quality of life. Numerous interventions like coffee drinking, chewing-gum together with enhanced recovery after surgery (ERAS) protocol are introduced in major abdominal surgery to reduce the postoperative incidence of POI [post-operative ileus].”
“Appetite level as an additional clinical manifestation of postsurgical bowel movement recurrence is an indirect sign of recovery after major abdominal surgery,” the authors continued. “All of the above-mentioned effects might have also contributed to the shorter hospitalization time in the reported PB group in analyzed material.”
The surgery itself is a major abdominal procedure, involving removing the first and second portions of the duodenum, removing the distal segment of the stomach, the head of the pancreas, the gallbladder, and common duct. To date, evidence supporting the effect of probiotics supplementation in major abdominal surgeries is limited, and even further limitations are present in surgeries involving the pancreas.
The clinical trial enrolled 40 patients undergoing PPPD, who were randomized into two groups, with a control group receiving standard nutrition, and another group of 20 participants treated with Lactobacillus rhamnosus GG in a 30-day period immediately following surgery.
Each group was monitored for gastrointestinal motility, infection complications, length of hospital stay, and mortality, and the results were compared at 14 days and 30 days after treatment. While there were no significant differences in the mortality and infectious complications between the two groups, the probiotic group’s hospital stay duration was two days shorter than that of the control group (8 vs. 10 days, respectively). Additionally, certain measures showed that the probiotic supported digestive recovery, with an earlier recurrence of postoperative bowel movements, averaging at 2.15 days for the probiotic group compared to 3.75 days for the control group, passing gasses (2.9 days vs. 4 days for the control group), and first postoperative stool (3.85 days vs. 5.84 days for the control group).
Subjectively, those who were administered probiotics also reported better appetites on postoperative day 1, 3, 5, 7, and 30 days after surgery.
“To our knowledge, this is the first study investigating the influence of single specimen probiotic containing L. rhamnosus GG strain on early post-operative outcomes after PPPD,” the authors of the study concluded. “Delayed gastric emptying is one of the most frequent complications in the early period after PPPD prolonging hospital stay, as well as impairing patients’ quality of life. Numerous interventions like coffee drinking, chewing-gum together with enhanced recovery after surgery (ERAS) protocol are introduced in major abdominal surgery to reduce the postoperative incidence of POI [post-operative ileus].”
“Appetite level as an additional clinical manifestation of postsurgical bowel movement recurrence is an indirect sign of recovery after major abdominal surgery,” the authors continued. “All of the above-mentioned effects might have also contributed to the shorter hospitalization time in the reported PB group in analyzed material.”
