Importance of preoperative and postoperative nutritional support in patients suffering from pancreatic head cancer

Ugroţen i loš nutritivni status nerijetko je oĉekivani dio tijeka zloćudne bolesti, njezina lijeĉenja i kasnijeg oporavka. Kada uzmemo u obzir karcinom glave gušteraĉe, kao ĉetvrtog uzroka smrti od karcinoma probavnog sustava, neupitna je njegova uska povezanost s problemom malnutricije (pothranjenosti). Prema nekim navodima, nenamjerno smanjenje prehrambenog unosa dogaĊa se u gotovo polovice novodijagnosticiranih bolesnika oboljelih od karcinoma glave gušteraĉe. Zbog nespecifiĉnosti simptoma ove bolesti, postavljanje dijagnoze je oteţano. Najĉešće se dokazuje kasno, u već uznapredovanoj fazi bolesti. Kirurška resekcija najĉešće postaje jedino kurativno lijeĉenje. Tada je najĉešće nutritivni status oboljelih već uvelike ugroţen i zahtjeva što raniju intervenciju. Njegova specifiĉna procjena i adekvatna nutritivna potpora sastavni su dio lijeĉenja kod pacijenata s karcinomom glave gušteraĉe. Povećani nutritivni rizik u ovih pacijenata javlja se kod gotovo 80% oboljelih. Predstavlja vaţan ĉimbenik koji u konaĉnici uvjetuje ishodu lijeĉenja i samom oporavku. Brojni su negativni uĉinci na nutritivni status, no u ovom sluĉaju, prema nizu istraţivanja na prvom je mjestu egzokrina insuficijencija gušteraĉe. Onemogućuje normalnu funkciju probavnog sustava te u konaĉnici uzrokuje kaheksiju i pothranjenost. Upravo iz tih razloga cilj mog rada bio je ukazati na vaţnost procjene nutritivnog statusa kod pacijenata s karcinomom glave gušteraĉe. Brojne studije su pokazale da kvalitetna nutritivna potpora olakšava kako postoperativni tako i preoperativni tijek lijeĉenja. Tom ĉinjenicom voĊeni moramo znati da je duţnost medicinskih djelatnika da pravovremenim metodama pristupe i procjene nutritivni status kako bi se što ranije odredili uvjeti nutritivne potpore. Nadalje se na taj naĉin osigurava poboljšanje nutritivnog statusa i znatno smanjenje perioperativnih komplikacija.The endangered and bad nutritional status is rarely expected course of malignant disease, treatment and later recovery. When we consider pancreatic cancer as the fourth death rate diminution cancers of digestive system diminution cancers its close connection to malnutrition is unquestionable. According to some sources, unintentional food diminution intake occurs in almost half of newly diagnosed patients with pancreatic cancer. Setting up diagnosis is difficult because of the unspecified symptoms of this disease. It is often proved late at an already advanced disease stage. Surgical resection is usually the only curative treatment. At that stage the nutritional status of patients is already greatly jeopardized and requires intervention as soon as possible. Specific assesment of the nutritive status and adequate nutritional support are crucial part of treating patients with pancreatic head cancer. Increased nutritional risk occurs in nearly 80% of the patients. It represents an important factor witch determines the course of treatment and patients recovery.There are numerous negative effects on the nutritional status, in this case, according to a series of studies the first place is exocrine pancreatic insufficiency. Exocrine pancreatis insufficiency disables the normal function of the digestive system and ultimately causes cachexia and malnutrition. Precisely for these reasons the goal of my work was to point out the importance of assessing the nutritional status in this type of illness. Numerous studies have shown that the quality of nutritional support makes it easier in the course of the preoperative and postoperative treatment. If we take all of this in consideration we have to know that it is a duty of medical staff to assess and evaluate the nutritive status so that nutritive support can be determend as soon as possible. That way ensvers improved nutritional status and significantly reduced perioperative complications.