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Review
. 2023 Apr 25;15(9):2466.
doi: 10.3390/cancers15092466.

Recent Advances in Pancreatic Ductal Adenocarcinoma: Strategies to Optimise the Perioperative Nutritional Status in Pancreatoduodenectomy Patients

James M Halle-Smith  1   2 , Sarah F Powell-Brett  1   2 , Lewis A Hall  1   2 , Sinead N Duggan  3 , Oonagh Griffin  4 , Mary E Phillips  5 , Keith J Roberts  1   2
Affiliations
Review

Recent Advances in Pancreatic Ductal Adenocarcinoma: Strategies to Optimise the Perioperative Nutritional Status in Pancreatoduodenectomy Patients

James M Halle-Smith et al. Cancers (Basel). .

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy for which the mainstay of treatment is surgical resection, followed by adjuvant chemotherapy. Patients with PDAC are disproportionately affected by malnutrition, which increases the rate of perioperative morbidity and mortality, as well as reducing the chance of completing adjuvant chemotherapy. This review presents the current evidence for pre-, intra-, and post-operative strategies to improve the nutritional status of PDAC patients. Such preoperative strategies include accurate assessment of nutritional status, diagnosis and appropriate treatment of pancreatic exocrine insufficiency, and prehabilitation. Postoperative interventions include accurate monitoring of nutritional intake and proactive use of supplementary feeding methods, as required. There is early evidence to suggest that perioperative supplementation with immunonutrition and probiotics may be beneficial, but further study and understanding of the underlying mechanism of action are required.

Keywords: nutrition; pancreatic ductal adenocarcinoma; surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Causes of Malnutrition in Pancreatic Cancer Patients. Created with biorender.com.
Figure 2
Figure 2
Pre- and post-operative interventions to improve the nutritional status of pancreatoduodenectomy patients. Created with biorender.com.
See this image and copyright information in PMC

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