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.