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Nutrición Hospitalaria
On-line version ISSN 1699-5198Print version ISSN 0212-1611
Abstract
LOINAZ SEGUROLA, C. and OCHANDO CERDAN, F.. Nutritional management of the patient after surgery of the biliary tract and pancreas. Nutr. Hosp. [online]. 2008, vol.23, suppl.2, pp.41-51. ISSN 1699-5198.
A big proportion of patients with biliary and pancreatic surgery present preoperative malnourishment aggravated by perioperative fasting and additional therapies. Surgery of the pancreas and the biliary tract may cause digestive impairments, mainly absorptive, especially with fat malabsorption. Many studies have shown the usefulness of nutritional support in gastrointestinal surgery. In the last years, there has been a remarkable effort in order to determine which are the best perioperative nutrition regimens in biliary and pancreatic surgery, particularly in the setting of duodenopancreatectomy. Generally, routinary parenteral nutrition (PNT) is not recommended, excepting in moderate-severe hyponutrition, the first choice therapy being enteral nutrition. Immunonutrition seems to improve the outcomes, and the best infusion might be cyclic. According to a survey carried out among the Hepatopancreatobiliary Surgery units in Spain, nowadays the most frequently used support regimen in biliary and pancreatic surgery is PNT, switching to oral feeding within 4-6 days. Enteral nutrition is seldom used.
Keywords : Biliary and pancreatic surgery; Nutritional management; Enteral nutrition.