Objective: Studies emphasize the importance of nutritional support in pancreatic cancer patients with malnutrition and suggest that immunonutrition products reduce postoperative morbidity compared to standard products. In this study, we evaluated the effect of standard nutritional support and immunonutrition on surgical site infection and postoperative length of hospital stay in patients undergoing pancreaticoduodenectomy for malignancy.

Methods: Patients who underwent pancreaticoduodenectomy between 2018 and 2022 were divided into 3 groups: those who received no nutritional support, those who received standard nutritional support, and those who received immunonutrition. Patients’ age, gender, body mass index, weight loss, Nutritional Risk Screening-2002 score, preoperative prealbumin and albumin values, whether they received nutritional support or not, the period of nutritional support use and whether standard nutritional support or immunonutrition was applied, postoperative surgical site infection development and length of hospital stay were evaluated.

Results: The study included 114 patients, 66 of whom were male. The mean age of the patients was 63.8 ± 10.45 years, the mean body mass index was 26.53 ± 5.29 kg/m2 , and the median Nutritional Risk Screening-2002 score was 4 (2-6). Weight loss was observed in 57% of the patients. Of the 65 patients with weight loss, 14 (21.5%) did not receive nutritional support. In total, 49 patients received immunonutrition. There were 31 patients in the no nutritional support group. When the groups were compared, the difference in the incidence of surgical site infection was significant (P=.030). However, there was no difference between the groups regarding length of hospital stay (P=.147). When the groups were compared among themselves, there was no difference in surgical site infection between the standard nutritional support or immunonutrition groups (P=.128). In those with weight loss, surgical site infection was highest in the no nutritional support group with 71.4%, while it was 23.3% and 23.8% in the immunonutrition and standard nutritional support groups, respectively (P=.004). Length of hospital stay was similar. In those without weight loss, there was no difference between the groups regarding surgical site infection and length of hospital stay (P=.057, P=.271, respectively).

Conclusion: In malnourished or at risk of malnutrition patients undergoing pancreaticoduodenectomy for periampullary site malignancy, nutritional support positively affects the development of surgical site infection, whereas specifically, immunonutrition does not reduce postoperative surgical site infection or length of hospital stay.

Keywords: Immunonutrition, morbidity, periampullary cancer