Results from a UK-wide survey: the nutritional assessment and management of pancreatic resection patients is highly variable.

Abstract

Most patients who undergo curative-intent resection for pancreatic cancer are malnourished. This correlates with poor outcomes. There are no guidelines for the nutritional management of these patients. We aimed to establish current UK practice by surveying all hepatopancreatobiliary (HPB) units. Questions covered: dietetic service, nutrition risk screening (RS), micronutrients, prehabilitation, nutritional support, pancreatic exocrine replacement therapy (PERT), and details of follow-up. Twenty-six units (83.9%) responded. Twenty-three (88.5%) provide a specialist HPB dietetic service. Twelve (52.2%) cover the entire treatment pathway. Thirteen (50.0%) routinely perform RS, eleven (42.3%) check micronutrients, and fourteen (53.8%) provide a prehabilitation programme. Twelve units (46.2%) allow nutritional supplements within 48 h of surgery, and eight (30.8%) do not allow this until at least 72 h. The use of PERT and acid-suppressing agents is highly variable. Seventeen units (65.4%) routinely provide dietitian follow-up. Practice is highly variable; robust studies are required so consensus guidelines can be formulated.