Pancreaticoduodenectomy: Effect of Nursing Instructions and Oral Postoperative Nutritional Supplementation on Patients Outcomes

Abstract

Background: Adequate dietary oral intake is important to maintain nutritional status for patients after pancreaticoduodenectomy. Aim: This study was conducted to evaluate the effect of nursing instructions and oral postoperative nutritional supplementation on outcomes of patients following pancreaticoduodenectomy. Patients and methods: Research design: Quasi experimental (non-randomized) design. Sample and setting: Thirty-four adult patients diagnosed with pancreatic cancer and underwent pancreaticoduodenectomy. Patients were assigned non-randomly into 2 groups. Admitted patients during the first six months in hepatobiliary surgical unit at Al-Rajhi Liver and Gastroenterology Assiut University Hospital were included as control group (16 patients), while patients admitted during the next six months were included as study group (18 patients). Tools: Patient assessment sheet, short-form mini nutritional assessment scale, and Clavien-Dindo classification of surgical complications. Results: Study finding revealed a statistical significant difference (p = 0.0001) with improvement in study group after 3 months postoperatively regarding nutritional status and albumin and protein levels. Reduced length of hospital stay for study group 10 (55.6%) less than 10 days compared to control group 10 (62.5%) from 10-15 days. Complications did not occur in about one-third of study group 6 (33.3%) compared to 3 (18.8%) in control group. Conclusion: Nursing instructions and oral postoperative nutritional supplementation reduced hospital stay, improved nutritional status, albumin and protein levels and reduced postoperative complications. Recommendation: Nursing instructions (educational booklet) and oral postoperative nutritional supplementation should be utilized in all liver and gastroenterology hospitals as teaching guide for patients undergoing pancreaticoduodenectomy.