Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

Results from a UK-wide survey: the nutritional assessment and management of pancreatic resection patients is highly variable

European Journal of Clinical Nutrition volume 76, pages 1038–1040 (2022)Cite this article

Subjects

Abstract

Most patients who undergo curative-intent resection for pancreatic cancer are malnourished. This correlates with poor outcomes. There are no guidelines for the nutritional management of these patients. We aimed to establish current UK practice by surveying all hepatopancreatobiliary (HPB) units. Questions covered: dietetic service, nutrition risk screening (RS), micronutrients, prehabilitation, nutritional support, pancreatic exocrine replacement therapy (PERT), and details of follow-up. Twenty-six units (83.9%) responded. Twenty-three (88.5%) provide a specialist HPB dietetic service. Twelve (52.2%) cover the entire treatment pathway. Thirteen (50.0%) routinely perform RS, eleven (42.3%) check micronutrients, and fourteen (53.8%) provide a prehabilitation programme. Twelve units (46.2%) allow nutritional supplements within 48 h of surgery, and eight (30.8%) do not allow this until at least 72 h. The use of PERT and acid-suppressing agents is highly variable. Seventeen units (65.4%) routinely provide dietitian follow-up. Practice is highly variable; robust studies are required so consensus guidelines can be formulated.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Responses from 26 UK HPB units.

Similar content being viewed by others

References

  1. Afaneh C, Gerszberg D, Slattery E, Seres DS, Chabot JA, Kluger MD. Pancreatic cancer surgery and nutrition management: a review of the current literature. Hepatobiliary Surg Nutr. 2015;4:59–71.

    PubMed  PubMed Central  Google Scholar 

  2. Ausania F, Senra P, Meléndez R, Caballeiro R, Ouviña R, Casal-Núñez E. Prehabilitation in patients undergoing pancreaticoduodenectomy: a randomized controlled trial. Rev Esp Enferm Dig. 2019;111:603–8.

    Article  Google Scholar 

  3. Phillips M, Lordan JT, Menezes N, Karanjia ND. Feeding patients following pancreaticoduodenectomy: a UK national survey. Ann R Coll Surg Engl. 2009;91:385–8.

    Article  Google Scholar 

  4. Martin D, Joliat GR, Halkic N, Demartines N, Schäfer M. Perioperative nutritional management of patients undergoing pancreatoduodenectomy: an international survey among surgeons. HPB (Oxf). 2020;22:75–82.

    Article  Google Scholar 

  5. Loinaz Segurola C, Ochando Cerdán F, Vicente López E, Serrablo Requejo A, López Cillero P, Gómez Bravo M, et al. Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain. Nutr Hosp. 2020;37:238–42.

    PubMed  Google Scholar 

  6. Shin SH, Kang W-H, Han IW, You Y, Lee H, Kim H, et al. National survey of Korean hepatobiliary-pancreatic surgeons on attitudes about the enhanced recovery after surgery protocol. Ann hepato-biliary-Pancreat Surg. 2020;24:477–83.

    Article  Google Scholar 

  7. La Torre M, Ziparo V, Nigri G, Cavallini M, Balducci G, Ramacciato G. Malnutrition and pancreatic surgery: prevalence and outcomes. J Surg Oncol. 2013;107:702–8.

    Article  Google Scholar 

  8. Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schäfer M, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg. 2013;37:240–58.

    Article  Google Scholar 

  9. Osland E, Yunus RM, Khan S, Memon MA. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN J Parenter Enter Nutr. 2011;35:473–87.

    Article  Google Scholar 

  10. Zhu X, Wu Y, Qiu Y, Jiang C, Ding Y. Comparative analysis of the efficacy and complications of nasojejunal and jejunostomy on patients undergoing pancreaticoduodenectomy. JPEN J Parenter Enter Nutr. 2014;38:996–1002.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank those who took the time to complete the survey.

Author information

Authors and Affiliations

  1. University Hospitals Plymouth NHS Trust, Derriford Road, Plymouth, PL6 8DH, UK

    Thomas B. Russell, Paula Murphy, Andrei Tanase & Somaiah Aroori

  2. Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK

    Gourab Sen

Authors
  1. Thomas B. Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paula Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrei Tanase
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gourab Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Somaiah Aroori
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualisation: PM, SA. Data curation: TR. Methodology: TR, PM, AT, GS, SA. Project administration: TR. Visualisation: TR, PM, AT, GS, SA. Writing – original draft: TR. Writing–review and editing: TR, PM, AT, GS, SA. Supervision: SA.

Corresponding author

Correspondence to Somaiah Aroori.

Ethics declarations

Competing interests

All authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Russell, T.B., Murphy, P., Tanase, A. et al. Results from a UK-wide survey: the nutritional assessment and management of pancreatic resection patients is highly variable. Eur J Clin Nutr 76, 1038–1040 (2022). https://doi.org/10.1038/s41430-021-01063-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-021-01063-5

Search

Advanced search

Quick links