Perioperative nutritional management of a Whipple’s patient

Abstract

Pancreatic cancers comprise one of the most difficult cancers to diagnose and one of the leading causes of cancer-related deaths in the world.^1,2 A 70-year-old male presenting with a head of pancreas malignant mass was referred for nutritional optimisation as part of the Enhanced Recovery After Surgery (ERAS) programme. He was planned for a pancreatoduodenectomy procedure, also known as a Whipple’s procedure. The patient’s nutritional status was assessed using the Nutritional Risk Screening 2002 (NRS-2002) tool and bioelectrical impedance analysis (BIA). He was classified as nutritionally at risk. This case study highlights the importance of perioperative nutrition care, the use of appropriate monitoring of body composition changes, where available, and employment of appropriate pharmacologic strategies. A significant improvement in weight, muscle mass and percentage body fat were observed once nutrition was initiated perioperatively. Despite complications during the patient’s postoperative phase, he still maintained a good nutritional status through adequate nutrition support.

Keywords: pancreatic cancer; nutritional balance; nutritional support; pancreatic enzyme replacement therapy; PERT