NUTRITIONAL SUPPORT ON POSTOPERATIVE WHIPPLE PROCEDURE OF

PANCREATIC HEAD CARCINOMA WITH HYPOALBUMINEMIA

Yosefa Ria Rampo1*, Nurpudji A. Taslim2
1
Clinical Nutrition Department Medical Faculty of Hasanuddin University, Makassar
*Korespondensi : yosefariarampo@yahoo.co.id

Abstract

Introduction

Pancreatic cancer is one of the most common gastrointestinal tumors found in the
pancreas region and is the fifth leading cause of death in developed countries including the
United States and Europe. The American Cancer Society estimates that by 2013 there are 45,220
people (22,740 men and 22,480 women) diagnosed with pancreatic cancer. Over 98% of
pancreatic cancer patients die and mostly die within six months of diagnosis, one of cancer-
related comorbidities is malnourished and this is associated with the risk of complications,
increased length of hospitalization and mortality, thus nutritional intervention is required.

Case Description
Mrs. J, Female, 64 years old, was consulted from the anesthesiologist with postoperative
Whipple Procedure of pancreatic head carcinoma with hypoalbuminemia. From the history it
was found that the patient was not allowed to eat and drink via oral by a digestive surgeon from
the previous 5 days, because the surgery will be done on April 2nd, 2018, with nasogastric tube,
black residue of 30 cc / 4 hours, there was abdominal pain, no fever . There was weight loss in
last 1 month about 6 kg. 24 hours energy intake was 0 kcal. Nutritional diagnosis were moderate
protein energy malnutrition (SGA), metabolic state of anemia (Hb 11,3), leukocytosis (WBC
12.300), severe immune system depletion (TLC 390 / uL), hypoalbuminemia (albumin 1.6 g /
dL), and functional gastrointestinal state
Nutritional therapy was given in the form of clear liquid diet in the form of dextrose 5% 5 x 20
cc, and through parenteral route by aminofluid 1000 cc / 24 hours. The type, amount and
composition are gradually increased according to the tolerance and condition of the patient up to
1600 kcal, 2 gr / kgIBW / day (25%) protein, 50% carbohydrate and 25% fat.
After 28 days of treatment, intake improved to 98.5% of total patient energy requirement,
abdominal circumference decreased, hemoglobin 12.7 g / dl, WBC 10.080 / uL, TLC 1250 cells /
mm3, albumin 2.9 g / dL.

Conclusion
Optimum nutritional support can accelerate healing in post operative pancreatic cancer patients,
increase albumin levels, and improve patient quality of life.

Keyword : pancreatic carcinoma, malnutrition, hypoalbuminemia