Postoperative Nutritional Supplement

Routine post-op care

Chang Moo Kang, MD, Ph.D

Decreased bowel function and loss of appetite in patients who underwent pancreaticobiliary surgery contribute impaired nutritional status in postoperative period. It can also affect perioperative and oncologic outcomes negatively. Therefore it is important to improve nutritional status in postoperative period by supply tailor-made optimal diets. The investigators have developed customized postoperative diets and products for pancreaticobiliary cancer patients. This time, newly developed ketogenic drink contain beefsteak mint.

The investigators expect that nutritional supplement for pancreaticobiliary patients will increase the food intake rate and contribute a improvement of perioperative outcomes and even oncologic outcomes.

Clinical Validation of Nutritional Supplements("Ketogenic Plus") Developed for Pancreaticobiliary Cancer Patients

Diet Intake Rate measured by dietary satisfaction questionnaire

Yonsei University

Ordinary Diet

Modified Atkin's Diet

Ketogenic Diet

Decreased bowel function and loss of appetite in patients who underwent pancreaticobiliary surgery contribute impaired nutritional status in postoperative period. It can also affect perioperative and oncologic outcomes negatively. Therefore it is important to improve nutritional status in postoperative period by supply tailor-made optimal diets. The investigators have developed customized postoperative diets for pancreaticobiliary cancer patients. The investigators expect that customized diets for pancreaticobiliary patients will increase the food intake rate and contribute a improvement of perioperative outcomes and even oncologic outcomes.

Development and Clinical Validation of Ketogen-based Therapeutic Diet for Pancreaticobiliary Cancer Patients

Diet Intake Rate(%) will be examined by dietary satisfaction questionnaires.

With Dunking Technique after Pancreaticodudenectomy

To compare between the outcomes of pancreaticogastrostomy and pancreaticojejunostomy with dunking technique after Pancreaticodudenectomy

Pancreaticogastrostomy versus Pancreaticojejunostomy with Dunking Technique

Sherif Alaa Abdelhafez, Resident

Mostafa Mahmoud, Ass. professor

To compare between the outcomes of pancreaticogastrostomy and pancreaticojejunostomy with dunking technique after Pancreaticodudenectomy in the treatment of operable periampullary malignancies.

Pancreaticoduodenectomy remains the treatment of choice for periampullary malignancies. Advances in pancreatic surgery techniques and perioperative care have led to reduced mortality rates for Pancreaticodudenectomy \[1\]. However, morbidity after pancreatic resection remains high, with 30-60% of patients experiencing complications following surgery, mainly as a result of leak and subsequent fistula from the pancreatic anastomosis \[2\].The leakage of the pancreatic anastomosis remains the most serious problem as it is the major cause of morbidity after pancreaticoduodenectomy, and also contributes significantly to prolonged hospitalization \[5\]. For this reason, surgeons have always directed their efforts at reducing the rate of pancreatic fistula through the introduction of new and effective methods of construction of the pancreatic anastomosis \[6\]. Various techniques have been described for joining the pancreatic stump either with the jejunum or with the stomach, with or without internal or external drainage of the pancreatic duct. Recently, new prospective randomized studies have demonstrated the advantage of pancreaticogastrostomy over pancreaticojejunostomy in reducing the incidence of pancreatic fistula \[3\]; however, none of these techniques has proved to be superior in minimizing postoperative mortality and morbidity \[4\]. One of the difficulties of pancreatic reconstruction after pancreaticoduodenectomy is the presence of soft pancreas which leads to high risk of fistula so dunking technique was raised \[8\]. But few researches or papers have focused on its efficacy and even fewer papers have discussed dunking in pancreaticogastrostomy and pancreaticojejunostomy, So this is the interest of our study to compare between the efficacies of these two techniques.

Pancreaticogastrostomy Versus Pancreaticojejunostomy With Dunking Technique After Pancreaticodudenectomy: A Prospective Randomized Comparative Study

Compare between dunking in pancreaticogastrostomy and pancreaticojejunostomy and the rate of postoperative anastomosis leakage

Assiut University

resident doctor

Routine post-op care + Nutritional supplement by specific product

Routine care + Nutritional product

Routine care

Decreased bowel function and loss of appetite in patients who underwent pancreaticobiliary surgery contribute impaired nutritional status in postoperative period. It can also affect perioperative and oncologic outcomes negatively. Therefore it is important to improve nutritional status in postoperative period by supply tailor-made optimal diets. The investigators have developed customized postoperative diets and products for pancreaticobiliary cancer patients. The investigators expect that nutritional supplement for pancreaticobiliary patients will increase the food intake rate and contribute a improvement of perioperative outcomes and even oncologic outcomes.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Clinical Validation of Nutritional Supplements("Ketogenic Plus") Developed for Pancreaticobiliary Cancer Patients	NCT03510429	Pancreaticobili...	Postoperative N... Routine post-op...	19 Years - 80 Years	Yonsei University
Development and Clinical Validation of Ketogen-based Therapeutic Diet for Pancreaticobiliary Cancer Patients	NCT02964806	Ketogen-based T... Pancreaticobili...	Ordinary Diet Modified Atkin'... Ketogenic Diet	19 Years - 80 Years	Yonsei University
Pancreaticogastrostomy Versus Pancreaticojejunostomy With Dunking Technique After Pancreaticodudenectomy: A Prospective Randomized Comparative Study	NCT05171361	Pancreaticobili...	Pancreaticogast...	18 Years - 75 Years	Assiut University
Clinical Validation of Nutritional Supplements("Ketogenic Plus") Developed for Pancreaticobiliary Cancer Patients	NCT03510429	Pancreaticobili...	Postoperative N... Routine post-op...	19 Years - 80 Years	Yonsei University
Clinical Validation of Nutritional Supplements Developed for Pancreaticobiliary Cancer Patients	NCT03294096	Pancreaticobili...	Routine care + ... Routine care	19 Years - 80 Years	Yonsei University
Pancreaticogastrostomy Versus Pancreaticojejunostomy With Dunking Technique After Pancreaticodudenectomy: A Prospective Randomized Comparative Study	NCT05171361	Pancreaticobili...	Pancreaticogast...	18 Years - 75 Years	Assiut University
Clinical Validation of Nutritional Supplements Developed for Pancreaticobiliary Cancer Patients	NCT03294096	Pancreaticobili...	Routine care + ... Routine care	19 Years - 80 Years	Yonsei University

Spots Global Cancer Trial Database for pancreaticobiliary cancer