hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2023-2-50-58hepato-1014Research ArticleПРОГРАММА УСКОРЕННОГО ВОССТАНОВЛЕНИЯ В ГЕПАТОПАНКРЕАТОБИЛИАРНОЙ ХИРУРГИИНутритивная поддержка как компонент программы ускоренного выздоровления в гепатопанкреатобилиарной хирургииNutritional support as a component of enhanced recovery program in hepatopancreatobiliary surgeryhttps://orcid.org/0000-0002-8121-4160ПасечникИ. Н.PasechnikI. N.

Пасечник Игорь Николаевич – доктор мед. наук, профессор, заведующий кафедрой анестезиологии и реаниматологии; главный внештатный специалист по анестезиологии-реаниматологии

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1А

141435, Московская обл., городской округ Химки, мкр. Новогорск, ул. Ивановская, д. 15

Igor N. Pasechnik – Doct. of Sci. (Med.), Professor, Head of Department of Anesthesiology and Resuscitation; Chief Independent

19, Bldg. 1A, Marshal Timoshenko str., 121359 Moscow

15, Ivanovskaya, Khimki city district micr. Novogorsk, Moscow region, 141435

pasigor@yandex.ruhttps://orcid.org/0000-0003-0951-1360АгаповК. В.AgapovK. V.

Агапов Константин Васильевич – доктор мед. наук, генеральный директор

141435, Московская обл., городской округ Химки, мкр. Новогорск, ул. Ивановская, д. 15

Konstantin V. Agapov – Doct. of Sci. (Med.), CEO

15, Ivanovskaya, Khimki city district micr. Novogorsk, Moscow region, 141435

info@fkc-vmt.ruФГБУ ДПО “Центральная государственная медицинская академия” Управления делами Президента РФ; ФГБУ “Федеральный клинический центр высоких медицинских технологий” Федерального медико-биологического агентства РоссииРоссияCentral State Medical Academy, Administrative Directorate of the President of the Russian Federation; Federal Clinical Center for High Medical Technologies, Federal Medical-Biological Agency (FMBA of Russia)Russian FederationФГБУ “Федеральный клинический центр высоких медицинских технологий” Федерального медико-биологического агентства РоссииРоссияFederal Clinical Center for High Medical Technologies, Federal Medical-Biological Agency (FMBA of Russia)Russian Federation2023140620232825058Copyright © Пасечник И.Н., Агапов К.В., 20232023Пасечник И.Н., Агапов К.В.Pasechnik I.N., Agapov K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/1014

Обзор литературы демонстрирует необходимость дифференцированного подхода к нутритивной поддержке больных, оперированных на органах гепатопанкреатодуоденальной зоны. Представлены сведения о практике проведения нутритивной поддержки больных этой категории. Подчеркнута необходимость оценки риска нутритивной недостаточности до хирургического вмешательства. Коррекцию пищевого статуса следует основывать на потребности в белке и энергии пациента с учетом сопутствующих заболеваний. Методом выбора являются препараты для сипинга. В послеоперационном периоде предпочтение следует отдавать энтеральному питанию. Активно обсуждают вид нутритивной поддержки пациентов, перенесших панкреатодуоденальную резекцию, запланировано рандомизированное клиническое исследование для оценки эффективности энтерального и парентерального питания. Нутритивная поддержка, являясь составной частью программы ускоренного выздоровления, позволяет оптимизировать результаты лечения пациентов, перенесших вмешательства на органах гепатопанкреатодуоденальной зоны. Обязательной является оценка нутритивного статуса больного до операции. Периоперационная коррекция пищевого статуса подразумевает преемственность и мультидисциплинарный подход.

According to the literature review, a nutritional support for patients after hepatopancreoduodenal surgery requires a differentiated approach. The paper presents data on the experience in providing nutritional support to this kind of patients. It is necessary to stress that nutritional risk screening should be performed prior to surgical intervention. The nutrition is recommended to be adjusted to protein and energy needs of the patient, taking into account concomitant diseases. Products for sip feeding are the method of choice. Enteral nutrition is preferable in the postoperative period. The nutritional support for patients undergoing pancreatoduodenal resection is increasingly recognized, and a randomized clinical trial is to be carried out to evaluate the effectiveness of enteral and parenteral nutrition. As a component of the enhanced recovery program, nutritional support can optimize outcomes in patients who have undergone hepatopancreatoduodenal resection. The nutritional status of a patient should be mandatorily assessed before surgery. Perioperative correction of nutritional status implies continuity and a multidisciplinary approach.

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The authors declare that there are no conflicts of interest present.