Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study
After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant...
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Published in | Annals of hepato-biliary-pancreatic surgery Vol. 28; no. 1; pp. 70 - 79 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Korea (South)
한국간담췌외과학회
01.02.2024
The Korean Association of Hepato-Biliary-Pancreatic Surgery |
Subjects | |
Online Access | Get full text |
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Summary: | After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes.
Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes.
In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m
(
= 0.03), absence of preoperative biliary stenting (
= 0.009), and serum albumin < 36 g/L (
= 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN.
A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 See Appendix 1 for a full list of the authors comprising the Recurrence After Whipple’s (RAW) study team (all collaborators are required to be PubMed citable and should be included in the online version of the published paper). |
ISSN: | 2508-5778 2508-5859 |
DOI: | 10.14701/ahbps.23-071 |