Routine dietetic counselling prior to major pancreatic surgery - A service improvement
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Petrova, A.
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2025
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Rationale: Dietetic (DT) optimisation prior to pancreatic surgery can improve nutritional outcomes (1). Our aim was to assess if routine pre-operative DT counselling is feasible and beneficial for clinical outcomes. Method(s): This is a prospective service improvement project for patients (PTs) undergoing Pylorus-preserving pancreaticoduodenectomy referred for exercise prehabilitation. DT prehabilitation was offered to all PTs and included: counselling on achieving adequate protein intake pre-operatively, the nutritional impact of the surgery, the role of nutrition in recovery and the role of pancreatic enzyme replacement therapy (PERT) post-operatively. Nutritional and/or PERT support were provided, if required. Data was collected over 3 months (Jan-March 25) and analysed on Excel. Malnutrition was diagnosed using Global Leadership Initiave for Malnutrition criteria. Post-operative length of stay (LoS) and PT feedback were primary outcomes. Result(s): Twelve PTs were included in the analysis. Majority (75%, n=9) were not malnourished. Only 18% (n=2) required PERT pre-operatively. Mean LoS was 14.4 (7-32) days. This was lower than 18.2 days (7-37) for exercise prehabilitation only cohort (Aug - Dec 24; n=13) and 16.7 days (4-39) for a baseline cohort without prehabilitation (Aug 21 - July 22; n=37). Eight PTs gave feedback (73%). All PTs found the service helpful (88% very, 12% somewhat), all found discussing PERT pre-operatively beneficial (88% very, 12% somewhat) and majority would recommend a routine pre-operative DT appointment (88% would;12% maybe). Conclusion(s): DT counselling pre-operatively was well received by PTs and may contribute to reduced LoS. Longer-term data is needed to evaluate the true impact on clinical outcomes. References: 1. Bibby N, Rajai A, O'Reilly DA. From prehab to rehab: Nutritional support for people undergoing pancreatic cancer surgery. Journal of Human Nutrition and Dietetics. 2023 Apr 1;36(2):493-503. Disclosure of Interest: None declared Copyright © 2025
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Clin.Nutr.ESPEN