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Supportive Care in Cancer

, Volume 27, Issue 3, pp 981–990 | Cite as

Application of an early oral feeding protocol after pylorus-preserving pancreaticoduodenectomy

  • Jungmin Cho
  • Hyung Mi Kim
  • Mina Song
  • Joon Seong ParkEmail author
  • Seung-Min LeeEmail author
Original Article
First Online:

Abstract

Purpose

This study evaluates the effect of an enhanced recovery after surgery (ERAS)-based nutrition support protocol on oral intake and weight change in patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD).

Methods

A 14-day postoperative nutrition support protocol was developed to initiate oral intake after 1 week of enteral tube feeding and parenteral nutrition (early oral feeding, EOF). Forty-eight patients who underwent PPPD participated in the study (non-EOF, n = 23; EOF, n = 25). General information, nutrition supply route and amount, blood chemistry, and weight changes were tracked.

Results

The enteral tube feeding duration was 2.7 days shorter in the EOF group than in the non-EOF group. Furthermore, the EOF group started oral liquid and soft diets 1.1 and 2.5 days earlier than the non-EOF group, respectively. Compared with the non-EOF group, the EOF group reported a higher energy intake (22.1%; p = 0.001) and protein intake (17.4%; p = 0.000) via oral route. Although cumulative energy and protein intakes were similar in both groups, weight reduction in the EOF group (3.6 ± 0.1%, 2.2 ± 0.7 kg) was significantly less than the non-EOF group (8.2 ± 0.9%, 5.2 ± 0.5 kg). The blood levels of total protein and transferrin increased and prealbumin decreased, regardless of the EOF application. Serum albumin increased significantly only in the EOF group.

Conclusion

The EOF protocol developed for post-PPPD patients enables the early initiation and increase in the amount of oral intake while significantly alleviating weight loss.

Keywords

Pylorus-preserving pancreaticoduodenectomy Early oral feeding Nutrition support protocol Oral diet intake Enteral tube feeding Weight change 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Nutrition Program, Graduate School of Human Environmental SciencesYonsei UniversitySeoulSouth Korea
  2. 2.Department of Nutrition, Gangnam Severance HospitalYonsei University Health SystemSeoulSouth Korea
  3. 3.Department of Food and Nutritional Science, College of Human EcologyYonsei UniversitySeoulSouth Korea
  4. 4.Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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