Oral Protein Supplements for Nutritional and Quality of Life Improvement After Pancreatic Resection in Elderly Patients

Oral Protein Supplements Might Improve Nutritional Status and Quality of Life in Elderly Patients After Standard Pancreatic Resection

This study investigates the effects of oral protein supplements on the nutritional status and quality of life in elderly patients following standard pancreatic resection. The research aims to determine whether these supplements can improve protein intake and contribute to better skeletal muscle mass, which is critical for recovery and overall health. The study hypothesizes that higher compliance with protein supplementation will be positively correlated with increased protein intake and improved muscle mass index, potentially leading to enhanced postoperative outcomes in this patient population.

This study was a randomized, double-blind, placebo-controlled clinical trial conducted to assess the effects of oral protein supplements on nutritional status and quality of life in elderly patients following pancreaticobiliary surgery. The study included elderly patients aged 65 years or older who underwent surgery for pancreaticobiliary cancer. The trial was conducted between January 7, 2021, and July 18, 2022.

A total of 60 patients were initially enrolled, but after 19 dropouts, the final analysis was based on 41 patients (18 in the placebo group and 23 in the experimental group). The experimental group received protein supplements providing 18g of protein per day, while the control group received a placebo containing carbohydrates instead of protein.

Key outcomes such as nutrient intake, nutritional status, quality of life, muscle mass, muscle strength, and 10-meter gait speed were measured at three time points: before surgery, at discharge, and during an outpatient visit. The data were analyzed using a Linear Mixed-Effects Model to evaluate the effects of the intervention.

Inclusion Criteria:

• Patients aged 65 years or older who were diagnosed with and underwent surgery for one of the following cancers:

  1. pancreatic cancer
  2. cholangiocarcinoma
  3. intraductal papillary mucinous neoplasm
  4. neuroendocrine tumor
  5. solid pseudopapillary tumor.

Exclusion Criteria:

• Patients were excluded from the study if they met any of the following criteria:

  1. Patients who were assessed as severely malnourished before surgery (PG-SGA grade C);
  2. Patients with an estimated glomerular filtration rate (eGFR) of less than 60 mL/min, or those diagnosed with chronic kidney disease and a history of related treatment;
  3. Patients with a body mass index (BMI) of 30 kg/m² or higher;
  4. Patients with ascites or edema severe enough to affect weight evaluation;
  5. Patients whose bioelectrical impedance analysis (BIA) could not be measured due to the use of pacemakers or implants;
  6. Patients whom the researcher deemed unable to participate in the study for psychological or cognitive reasons;
  7. Patients who did not provide consent for participation in this study.