Strategy of perioperative nutrition therapy for pancreatic cancer
Zheng Xin, Sun Bei
Department of Pancreatic and Biliary Surgery the First Affiliated Hospital of Harbin Medical University & Key Laboratory of
Hepatosplenic Surgery Ministry of Education
Abstract：Patients with pancreatic cancer are susceptible to perioperative malnutrition. Preoperative malnutrition factors include
pancreatic insufficiency and tumor-induced metabolic changes postoperative stress and inflammation increase the risk of short-term
nutritional deterioration and perioperative malnutrition is an independent risk factor for overall poor prognosis so it is necessary to
carry out a comprehensive nutritional management. Nutritional screening is routinely performed after admission and quantitative
nutritional screening tools can be used to determine the nutritional risk. Further nutritional assessment is required for patients with
higher nutritional risk. Enhanced recovery after surgery suggests that nutritional therapy should be performed for patients who have lost
more than 15% of their body weight or have a body mass index of less than 18. 5 kg / m
2
before surgery and nutritional therapy should
be based on the principle of stepwise escalation. The preoperative nutritional status will affect the timing of surgery. A single indicator
cannot completely describe the nutritional status of postoperative patients and it is recommended to use multiple methods to
dynamically monitor the nutritional status and analyze it comprehensively. Postoperative nutritional therapy should be individualized in
accordance with the patient 's condition and nutritional status and a reasonable choice of nutritional support pathway can avoid
additional pain and economic burden for patients. Early oral feeding is considered to be safe and effective but artificial nutrition should
be initiated in time for patients with poor oral tolerance. Enteral nutrition has advantages such as maintaining intestinal function but
total parenteral nutrition is of great value in the treatment of severe intestinal fistula delayed gastric emptying and other
complications.
