Flick, K. F.Soufi, M.Yip-Schneider, M. T.Simpson, R. E.Colgate, C. L.Nguyen, T. K.Ceppa, E. P.House, M. G.Zyromski, N. J.Nakeeb, A.Schmidt, C. M.2022-11-222022-11-222021Flick, K. F., Soufi, M., Yip-Schneider, M. T., Simpson, R. E., Colgate, C. L., Nguyen, T. K., Ceppa, E. P., House, M. G., Zyromski, N. J., Nakeeb, A., & Schmidt, C. M. (2021). Routine Gastric Decompression after Pancreatoduodenectomy: Treating the Surgeon? Journal of Gastrointestinal Surgery, 25(11), 2902–2907. https://doi.org/10.1007/s11605-021-04971-w1091-255X, 1873-4626https://hdl.handle.net/1805/30593Background The decision to routinely leave a nasogastric tube after pancreatoduodenectomy remains controversial. We sought to determine the impact of immediate nasogastric tube removal versus early nasogastric tube removal (<24 h) on postoperative outcomes. Methods A retrospective review of our institution’s prospective ACS-NSQIP database identified patients that underwent pancreatoduodenectomy from 2015 to 2018. Outcomes were compared among patients with immediate nasogastric tube removal versus early nasogastric tube removal. Results A total of 365 patients were included in primary analysis (no nasogastric tube, n = 99; nasogastric tube removed <24 h, n = 266). Thirty-day mortality and infectious, renal, cardiovascular, and pulmonary morbidity were similar in comparing those with no nasogastric tube versus early nasogastric tube removal on univariable and multivariable analyses (P > 0.05). Incidence of delayed gastric emptying (11.1 versus 13.2%) was similar between groups. Patients with no nasogastric tube less frequently required nasogastric tube reinsertion (n = 4, 4%) compared to patients with NGT <24 h (n = 39, 15%) (OR = 3.83, 95% CI [1.39-10.58]; P = 0.009). Conclusion Routine gastric decompression can be safely avoided after uneventful pancreaticoduodenectomy.en-USCC0 1.0 UniversalDelayed gastric emptyingNasogastric decompressionPancreatoduodenectomyArticle