title: Feeding patients following pancreaticoduodenectomy: a UK national survey.
abstract: BACKGROUND
  Providing nutrition for patients following pancreaticoduodenectomy (PD) is vital but can be challenging. Due to the lack of UK national guidelines for the provision of nutrition and nutritional pre-operative assessment regarding PD, a national survey was conducted.
  
  
  METHODS
  A questionnaire was sent to the Department of Nutrition and Dietetics at each of the 31 specialist pancreatic centres listed with the Pancreatic Society of Great Britain and Ireland. Questions were asked regarding the nutritional assessment and treatment of patients undergoing classical PD and pylorus-preserving PD (PPPD) resections.
  
  
  RESULTS
  Twenty-two centres responded to the questionnaire. With regard to PD and PPPD, 82% routinely feed patients following resection, 32% have a regimen for staring feeds, 18% carry out pre-operative nutritional assessment, five centres have funding for an hepatobiliary dietition, and only four centres have a specialist hepatobiliary dietition employed. There was no consensus regarding the type or route of feeding, and at least one centre reported using parenteral nutrition exclusively.
  
  
  CONCLUSIONS
  Very few centres in the UK have funding for a hepatobiliary dietition. Hence pre-operative nutritional assessment in patients undergoing PD and PPPD does not receive much input. Although the importance of postoperative feeding in these patients is appreciated in all major units, there is no consensus with regards to feeding regimens. The authors hope this observational study will address these issues with this important message and stimulate further study in this area.
authors.affiliation: The Royal Surrey County Hospital, Guildford, Surrey, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Phillips
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Lordan
authors.forename: Neville
authors.initials: N
authors.lastname: Menezes
authors.forename: Nariman D
authors.initials: ND
authors.lastname: Karanjia
mesh_terms: D019538:Health Care Surveys; D006801:Humans; D009752:Nutritional Status / Q000502:physiology; D018529:Nutritional Support / Q000379:methods*; D016577:Pancreaticoduodenectomy; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care; D011795:Surveys and Questionnaires; D006113:United Kingdom