Metabolic abnormalities and catheter-related infections are common complications of parenteral nutrition (PN). Particulate contamination is a catheter-related complication can occur when administering PN: mixing the electrolytes, trace elements, vitamins into the PN, or puncturing a rubber stopper at the PN formulation. In addition, the aggregation of the components of the PN solution by a drug incompatibility reaction could be related to particulate contamination. PN contaminated with precipitates, insoluble particles, and bacteria was reported as the cause of the death of a patient. The Food and Drug Administration recommended that the filters be used during PN administration. In-line filters can retain the bacteria and insoluble particles in PN solutions, and prevent their infusion into the patient. Therefore, in-line filters are recommended to prevent catheter-related complications that can occur during PN infusion. A 0.2
Malnutrition affects the clinical outcomes of pancreatic disease. On the other hand, the changes in the nutritional status stratified by malignant and non-malignant diseases after surgery still need to be determined. The aim was to confirm the changing nutritional status and clinical outcomes after a pancreatoduodenectomy according to malignant and non-malignant disease.
Data were collected prospectively from 157 patients between 2009 and 2015. The nutritional status was classified as well-nourished, at-risk of malnutrition, and malnourished by a Mini Nutrition Assessment. The clinical outcomes were assessed using the postoperative complication, hospital stay, biochemical nutritional markers, and quality-of-life (QOL).
Preoperatively, the proportion of malnourished status in the malignant disease group (group B) were 66.7% and 33.3% in the non-malignancy group (group A). The malnutrition rate in group B was higher than that in group A at 3, 6, and 12 months after surgery (58.1% vs. 41.9%, 90.0% vs. 10.0, 77.8% vs. 22.2%, respectively). The preoperative QOL was significantly lower in group B than in group A (P<.001); however, the QOL was comparable between the two groups after surgery. The body mass index was unrecovered after surgery in all groups.
Patients with malignant pancreatic disease are more likely to suffer from a poor nutritional status than those with non-malignant pancreatic disease. One year after the pancreatoduodenctomy, the at-risk of malnutrition and malnourished rate were found to be over 70% in all patients. Therefore, more efforts will be needed to improve the nutritional status in pancreatic head disease.