Perioperative Nutritional Aspects in Total Pancreatectomy: A Comprehensive Review of the Literature

Overview

Journal Nutrients

Date 2021 Jun 2

PMID 34067286

Citations 4

Authors

Niccolo Furbetta

Annalisa Comandatore

Desiree Gianardi

Matteo Palmeri

Gregorio Di Franco

Simone Guadagni

Giovanni Caprili

Matteo Bianchini

Lorenzo Maria Fatucchi

Martina Picchi

Luca Bastiani

Giandomenico Biancofiore

Giulio Di Candio

Luca Morelli

Affiliations

Soon will be listed here.

Abstract

Total pancreatectomy (TP) is a highly invasive procedure often performed in patients affected by anorexia, malabsorption, cachexia, and malnutrition, which are risk factors for bad surgical outcome and even may cause enhanced toxicity to chemo-radiotherapy. The role of nutritional therapies and the association between nutritional aspects and the outcome of patients who have undergone TP is described in some studies. The aim of this comprehensive review is to summarize the available recent evidence about the influence of nutritional factors in TP. Preoperative nutritional and metabolic assessment, but also intra-operative and post-operative nutritional therapies and their consequences, are analyzed in order to identify the aspects that can influence the outcome of patients undergoing TP. The results of this review show that preoperative nutritional status, sarcopenia, BMI and serum albumin are prognostic factors both in TP for pancreatic cancer to support chemotherapy, prevent recurrence and prolong survival, and in TP with islet auto-transplantation for chronic pancreatitis to improve postoperative glycemic control and obtain better outcomes. When it is possible, enteral nutrition is always preferable to parenteral nutrition, with the aim to prevent or reduce cachexia. Nowadays, the nutritional consequences of TP, including diabetes control, are improved and become more manageable.

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