Clin Nutr Res.  2016 Jul;5(3):213-218. 10.7762/cnr.2016.5.3.213.

Preoperative Oral Carbohydrate Loading in Pancreaticoduodenectomy

Affiliations
  • 1Department of Clinical Nutrition, National Cancer Center, Goyang 10408, Korea. gawie@ncc.re.kr
  • 2Center for Liver Cancer, National Cancer Center, Goyang 10408, Korea.
  • 3Nutrition Support Team, National Cancer Center, Goyang 10408, Korea.

Abstract

Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery.

Keyword

Preoperative carbohydrate loading; Preoperative fasting; Insulin resistance

MeSH Terms

Anesthesia
Fasting
Humans
Insulin Resistance
Pancreaticoduodenectomy*

Reference

1. Boyle HE, Hewer CL. Practical anaesthetics. 3rd ed. London: Frowde, Hodder and Stoughton;1923.
2. Nygren J, Thorell A, Jacobsson H, Larsson S, Schnell PO, Hylén L, Ljungqvist O. Preoperative gastric emptying. Effects of anxiety and oral carbohydrate administration. Ann Surg. 1995; 222:728–734.
Article
3. Ljungqvist O. Modulating postoperative insulin resistance by preoperative carbohydrate loading. Best Pract Res Clin Anaesthesiol. 2009; 23:401–409.
Article
4. Smith I, Kranke P, Murat I, Smith A, O'Sullivan G, Søreide E, Spies C, in't Veld B; European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011; 28:556–569.
5. Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schäfer M, Parks RW, Fearon KC, Lobo DN, Demartines N, Braga M, Ljungqvist O, Dejong CH, Cornelis H; ERAS® Society; European Society for Clinical Nutrition and Metabolism; International Association for Surgical Metabolism and Nutrition. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr. 2012; 31:817–830.
Article
6. Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015; 123:1455–1472.
Article
7. Ljungqvist O, Efendic S, Eneroth P, Hamberger B, Nylander G, Ware J. Nutritional status and endocrine response to hemorrhage. Can J Physiol Pharmacol. 1986; 64:1185–1188.
Article
8. Ljungqvist O, Soop M, Hedström M. Why metabolism matters in elective orthopedic surgery: a review. Acta Orthop. 2007; 78:610–615.
Article
9. Mortensen K, Nilsson M, Slim K, Schäfer M, Mariette C, Braga M, Carli F, Demartines N, Griffin SM, Lassen K; Enhanced Recovery After Surgery (ERAS®) Group. Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Br J Surg. 2014; 101:1209–1229.
10. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, Macfie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O; Enhanced Recovery After Surgery (ERAS) Society, for Perioperative Care; European Society for Clinical Nutrition and Metabolism (ESPEN); International Association for Surgical Metabolism and Nutrition (IASMEN). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. World J Surg. 2013; 37:259–284.
Article
11. Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN, Ljungqvist O, Soop M, Ramirez J; Enhanced Recovery After Surgery (ERAS) Society, for Perioperative Care; European Society for Clinical Nutrition and Metabolism (ESPEN); International Association for Surgical Metabolism and Nutrition (IASMEN). Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. World J Surg. 2013; 37:285–305.
Article
12. Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, Kassouf W, Muller S, Baldini G, Carli F, Naesheimh T, Ytrebo L, Revhaug A, Lassen K, Knutsen T, Aarsether E, Wiklund P, Patel HR. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS(®)) society recommendations. Clin Nutr. 2013; 32:879–887.
Article
13. Soop M, Nygren J, Myrenfors P, Thorell A, Ljungqvist O. Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance. Am J Physiol Endocrinol Metab. 2001; 280:E576–83.
Article
14. Yuill KA, Richardson RA, Davidson HI, Garden OJ, Parks RW. The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively--a randomised clinical trial. Clin Nutr. 2005; 24:32–37.
Article
15. Noblett SE, Watson DS, Huong H, Davison B, Hainsworth PJ, Horgan AF. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis. 2006; 8:563–569.
Article
16. Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014; CD009161.
Article
17. Fujikuni N, Tanabe K, Tokumoto N, Suzuki T, Hattori M, Misumi T, Ohdan H. Enhanced recovery program is safe and improves postoperative insulin resistance in gastrectomy. World J Gastrointest Surg. 2016; 8:382–388.
Article
18. Svanfeldt M, Thorell A, Hausel J, Soop M, Rooyackers O, Nygren J, Ljungqvist O. Randomized clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics. Br J Surg. 2007; 94:1342–1350.
Article
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