A Comparative Study of Post Operative Cases of Obstructive Jaundice with Versus Without Nasogastric Tube Insertion

Abstract: Background: Obstructive jaundice which can be either due to intra-hepatic Cholestatic or extra-hepatic biliary obstruction is amenable to surgical treatment. Hence, it is also called surgical jaundice. It is the practice of many surgeons to routinely use nasogastric tube after biliary operations, but its usefulness has been questioned. This study designed to determine the usefulness of postoperative nasogastric intubation on gastrointestinal function in operated patients of obstructive jaundice. Aims and objectives: To compare post-operative cases of obstructive jaundice with versus without Nasogastric Tube insertion in terms of nausea, vomiting, passage of flatus, respiratory complication, post-operative ileus, starting time of oral intake, post-operative pain, anastomotic leakage, wound dehiscence, wound infection, hospital stay, morbidity and mortality, patient compliance. Methods and materials: This study is a Randomised (Prospective and Interventional) clinical trial of 50 patients with the obstructive jaundice hospitalised in the Department of General Surgery, in our Hospital, between Oct 2015 to Oct 2017. Results: Age of Participants included in this study were above 20 year and Age of maximum participants were in between 40 and 60. Participants included were 37% male and 63% female. patients underwent choledocholithotomy, choledochoduodenostomy and Choledochojejunostomy. While most of the participants underwent Choledochoduodenostomy. All participants experienced nausea on the day of surgery. The highest rate of vomiting occurred on the day of operation. The highest rate of passage of flatus was reported on the day of operation. The Mean length of hospital stay after surgery was equal in both control and experimental groups. Conclusion: Results of the study revealed that patients with no nasogastric intubation did not show any increased postoperative complications (including anastomotic leak) or prolonged hospital stay. On the other hand, the nasogastric tube postpones return of bowel sounds and the first passage of flatus; increase the incidence of nausea while does not affect the incidence of postoperative ileus. Therefore, routine nasogastric tube usage is not recommended after surgery of patients with the obstructive jaundice.