Nutritional recommendations for patients with pancreatic head cancer after surgery

Introduction
Patients with pancreatic cancer experience many discomforts that affect the quality of life and nutritional status. It becomes a major therapeutic challenge to create an individualized nutritional plan for the patient. Recommendations should take into account not only the patient's nutritional and energy needs, but also the ongoing inflammation, coexisting conditions or taste preferences. The dynamics of metabolic changes resulting from the course of the disease as well as the applied treatment is also important. The main difficulties are nutritional deficiencies, malabsorption and digestion, and glycemic fluctuations. The aim of this article was to review available publications and to collect practical guidelines for nutrition during the perioperative period in patients with pancreatic head cancer.

Review
There are many risk factors involved in the pathogenesis of pancreatic malignancies. They mainly include: genetic predisposition, chronic pancreatitis or excessive alcohol consumption. The symptoms are not specific and often appear when the disease is far advanced. The only treatment is a surgery. Whipple pancreatoduodenectomy is the most common surgical treatment for pancreatic head cancer.

Conclusions
A detailed assessment of the nutritional status of the patient is a necessary step before starting nutritional therapy. Dietary recommendations should be individualized and include the dynamics of changes in ailments and nutritional disorders of the patient. After the procedure, early oral nutrition is recommended. Parenteral nutrition should be used in the case of malnourished patients or when they cannot ingest food enterally for a period of 7-10 days after surgery.