NUTRITIONAL-STATUS AND FUNCTION IN PATIENTS FOLLOWING WHIPPLE PROCEDURE COMPARED WITH CONTROLS

Objective: Despite the potential for nutritional deficits in patients undergoing pancreaticoduodenectomy or Whipple procedure, long-term ass essment of nutritional status has largely been ignored. This study ass essed nutritional status of 24 Whipple patients compared with matched post-cholecystectomy controls. Methods: Clinical assessment was by sub jective global assessment, body composition was assessed by bioelectri c impedance analysis and functional assessment was by respiratory musc le strength and skeletal muscle function performed by electrical stimu lation of the ulnar nerve of the wrist and hand-grip dynamometry. Resu lts: Whipple patients studied 4.6 +/- 0.7 years since surgery and cont rols (4.8 +/- 0.7 years since surgery) were all judged clinically to b e in a good nutritional state. Compared with controls, Whipple patient s had significantly lower body weight (Whipple: 72.5 +/- 2.8 kg, contr ol: 83.9 +/- 3.3 kg, p < 0.05) however, the mean body weight of both W hipple and controls was above ideal weight (Whipple: 113.3 +/- 4.3%, c ontrol: 122.3 +/- 3.7% p = NS). No significant differences in function al performance were observed between groups. Energy intake of Whipple and controls was also comparable. In the Whipple group, neither the ex tent of gastric resection or the pathological diagnosis had an effect on the nutritional parameters studied. Conclusions: Long-term follow-u p of patients having undergone Whipple procedure failed to reveal the presence of any nutritional or functional deficits suggesting that a f ull nutritional recovery is possible after this surgery.