Nutritional and anthropometric assessment of the scope for dietary optimization during staging prior to pancreaticoduodenectomy.

CONTEXT: Although several studies have examined peri-operative nutritional supplementation in patients undergoing pancreaticoduodenectomy all provided support at various timepoints with a variety of protocols.

OBJECTIVE: This study undertakes a detailed nutritional and anthropometric assessment of patients due to undergo pancreaticoduodenectomy with particular reference to pre-operative nutritional status and peri-operative outcome.

PATIENTS: Twenty-six patients undergoing pancreaticoduodenectomy.

SETTING: A regional hepatobiliary service.

MAIN OUTCOME MEASURES: Nutritional, anthropometric and clinical course details.

DESIGN: Data were collected prospectively.

RESULTS: There was no significant change in any anthropometric index from baseline to immediately prior to surgery. However, there was a significant fall in BMI comparing baseline measurements to observations at time of discharge from hospital (P<0.001). There was, in addition, a significant difference between baseline and BMI at 3 months (P<0.001). Similar trends were observed in mid-arm circumference, triceps skin fold thickness and hand-grip. There was no in-hospital or 3-month post-operative mortality in this series.

CONCLUSION: Nutritional and anthropometric indices remain stable from the time of index admission to operation. However, there is a drastic and sustained reduction in nutritional indices in the post-operative period with this deficiency being sustained at 3-months after operation.