Longitudinal dietitian follow-up after pancreatectomy and post-operative outcomes.

Abstract

695 Background: Adequate nutrition is essential to post-operative recovery in reducing complications and hospital length of stay after oncologic pancreatectomy. Dietitians are included in many pancreatic cancer multidisciplinary teams; however, few studies have investigated the impact of dietitian-led nutritional care following pancreatectomy. Methods: We conducted a retrospective chart review to evaluate outcomes related to nutritional care after pancreatectomy. The cohort was comprised of patients treated with oncologic pancreaticoduodenectomy or pancreatectomy at a single center between Jan-2015 and Jun-2025. Data collection included demographic data, use of enteral nutritional support, use of pancreatic enzyme replacement therapy (PERT), 90-day post-operative hospital readmissions, and longitudinal weight and micronutrient levels. Patients were categorized by whether or not they received dietitian-led nutrition care in the post-operative period (DC+ vs. DC-). Lack of dietitian-led care was principally driven by dietitian staffing schedules. Dietitian-led care focused on reducing post-operative weight loss, management of enteral feedings, surveillance of micronutrient deficiencies and ongoing reinforcement of and education about PERT. We compared weight change from the pre-operative baseline at 3, 6 and 12 months in the DC+ and DC- groups; the comparison at 3 months used a t-test and comparisons at 6 and 12 months used a linear mixed model for longitudinal data. Results: We identified 188 patients treated with oncologic pancreatectomy during the study period. The median age was 67 years, and 46.3% were female. The most common cancer diagnosis was pancreatic cancer (59.0%) and 151 of 188 patients (80.3%) received post-operative dietitian-led nutrition care (DC+ group). Mean weight change at 3 months after surgery was -6.5 kg in DC+ patients and -11.2 kg in DC- patients. Weight loss at 3 months was significantly less in DC+ patients (difference = 4.8 kg [95%CI 3.0, 6.5, p<0.001]). Mean weight loss at 6 and 12 months after pancreatectomy was numerically less in DC+ patients, but between-group differences were not statistically significant (estimated difference at 6 months = 1.2 kg [95%CI -2.0, 4.5], estimated difference at 12 months = 1.7 kg [95%CI -1.9, 5.4]). Conclusions: Patients who received dietitian-led nutrition care had less weight loss at three months after pancreatectomy than patients who did not receive dietitian-led care. This finding suggests a potentially meaningful benefit of dietitian-led post-operative nutrition care following oncologic pancreatectomy.