Perioperative Nutritional Aspects in Total Pancreatectomy: A Comprehensive Review of the Literature
Open accessAbstract
Total pancreatectomy (TP) is a highly invasive procedure often performed in patients affected by anorexia, malabsorption, cachexia, and malnutrition, which are risk factors for bad surgical outcome and even may cause enhanced toxicity to chemo-radiotherapy. The role of nutritional therapies and the association between nutritional aspects and the outcome of patients who have undergone TP is described in some studies. The aim of this comprehensive review is to summarize the available recent evidence about the influence of nutritional factors in TP. Preoperative nutritional and metabolic assessment, but also intra-operative and post-operative nutritional therapies and their consequences, are analyzed in order to identify the aspects that can influence the outcome of patients undergoing TP. The results of this review show that preoperative nutritional status, sarcopenia, BMI and serum albumin are prognostic factors both in TP for pancreatic cancer to support chemotherapy, prevent recurrence and prolong survival, and in TP with islet auto-transplantation for chronic pancreatitis to improve postoperative glycemic control and obtain better outcomes. When it is possible, enteral nutrition is always preferable to parenteral nutrition, with the aim to prevent or reduce cachexia. Nowadays, the nutritional consequences of TP, including diabetes control, are improved and become more manageable.
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Surgical procedures on the pancreas, especially total pancreatectomy, are associated with a considerable risk of morbidity and mortality.
“Of note, surgical procedures on the pancreas, especially total pancreatectomy, are associated with a considerable risk of morbidity and mortality [33,66-68].”
From An Uncommon Cause of Recurrent Presyncope, Dizziness, and Tachycardia: A Case Report of Diffuse, Adult-Onset Nesidioblastosis/Non-Insulinoma Pancreatogenous Hypoglycemia Syndrome (NIPHS) (2023) · cites this paper as [68]
The Introduction describes total pancreatectomy as highly invasive, and Section 4.3 explicitly associates it with postoperative morbidity. The passages found do not establish a considerable risk of mortality from the procedure; the broader claim about pancreatic surgery is also less directly addressed. (LLM, conf=0.84)
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Flagged first, then by citations
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- Authors
- Furbetta, N., Comandatore, A., Gianardi, D., Palmeri, M., Di Franco, G., Guadagni, S., Caprili, G., Bianchini, M., Fatucchi, L. M., Picchi, M., Bastiani, L., Biancofiore, G., Di Candio, G., & Morelli, L.
- Affiliations
- University of Pisa (IT)
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
- Istituto di Fisiologia Clinica (IT)
- Division of Transplant Anesthesia and Critical Care, University of Pisa, 56124 Pisa, Italy
- Corresponding author
- Morelli, Luca
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-05-22
- Volume
- 13
- Issue
- 6
- Pages
- 1765
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC8224756
- OpenAlex
- W3165667871
- Cited by
- 18
- References
- 106
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 2
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Keywords
- total pancreatectomy, perioperative nutrition, nutritional status, sarcopenia, body mass index, serum albumin, prognostic factors, pancreatic cancer, chronic pancreatitis, enteral nutrition, parenteral nutrition, cachexia, diabetes management, postoperative glycemic control
- MeSH terms
- Female, Humans, Male, Nutritional Status, Pancreatectomy, Pancreatic Neoplasms, Postoperative Complications, Prognosis, Risk Factors, Serum Albumin, Body Mass Index, Islets of Langerhans Transplantation, Nutrition Therapy, Pancreatitis, Chronic, Sarcopenia
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