P1062 - FROM GUIDELINES TO PRACTICE: NUTRITIONAL THERAPY AND ADHERENCE IN WHIPPLE PROCEDURE PATIENTS- A RETROSPECTIVE STUDY

P1062

FROM GUIDELINES TO PRACTICE: NUTRITIONAL THERAPY AND ADHERENCE IN WHIPPLE PROCEDURE PATIENTS- A RETROSPECTIVE STUDY

M. Da Silva^1,*, O. Wallengren¹

¹Clinical Nutrition unit, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

Rationale: Malnutrition is prevalent in patients undergoing the Whipple procedure for pancreatic cancer, significantly impacting clinical outcomes. Despite established nutritional guidelines, adherence and malnutrition incidence at Sahlgrenska University Hospital (SU) remain unclear.

Methods: This retrospective observational study analyzed medical records of 139 patients who underwent the Whipple procedure at SU in 2021–2022. Malnutrition was defined using Global Leadership Initiative on Malnutrition (GLIM) criteria. Nutritional treatment adherence was assessed based on local, national, and international guidelines. Associations between nutritional parameters, postoperative weight changes, and clinical outcomes were evaluated.

Results: Preoperative malnutrition was present in 51% of patients. Mean postoperative weight loss was 5.3% at one month and 7.5% at three to six months. Oral and total energy intake during hospitalization were low, reaching at most 39% and 72% of estimated needs, respectively. Total energy intake was positively associated with postoperative weight changes (p = 0.02). All patients received intravenous glucose, and 67% also received parenteral nutrition. Adherence to nutritional guidelines varied across criteria (34%–100%), with a median compliance of 82%. Reoperation reduced adherence from 82% to 77% (p = 0.03); however, adherence was not associated with 30-day readmission or 1-year mortality.

Conclusion: Patients undergoing the Whipple procedure are highly vulnerable to malnutrition. Despite high adherence to nutritional guidelines, energy intake during hospitalization remained insufficient, contributing to postoperative weight loss. Strategies to improve oral and total energy intake, such as snacks, fortification, and optimized artificial nutrition, should be prioritized to enhance nutritional outcomes.

Disclosure of Interest: None declared