Introduction : Nutritional assessment is critical in the determination of the nutritional status for major surgery. Pancreaticoduodenectomy is a major surgical procedure which is performed for pancreatic pathologies. We aim to evaluate the effect of pre-operative nutritional assessment on the morbidity and overall survival after pancreaticoduodenectomy in primary pancreatic pathology.

Methods : The data of 191 patients who underwent pancreaticoduodenectomy due to primary pancreatic pathology were prospectively collected from September 2008 to June 2014 in a single high volume institution. Mini Nutritional Assessment (MNA) was performed which divides the study group into 3 subgroups – normal, risk of malnutrition and malnutrition. Demographic, outcome and survival data were collected.

Results : The mean age is 61.0±11.6 years-old and mean pre-operative BMI is 23.2±3.1. The result of the MNA are normal (17.8%), risk of malnutrition (65.4%) and malnutrition (16.8%). The more advanced the tumour staging, the higher the incidence of malnutrition (p=0.017). The overall survival (OS) in both the immediate and long-term is higher in patients with normal nutrition as compared to those with progressive stages of malnutrition (p=0.001), with 97.1% 1-year OS, 91.1% 3-year OS and 83.5% 5-year OS for the normal nutrition group, 90.4%, 61.1% and 49.5% in the risk of malnutrition group, and 75.0%, 46.9% and 39.3% respectively for the malnutrition group.

Conclusions : In patients with malignant pancreatic pathology, advanced tumour staging is associated with a higher degree of malnutrition. Overall survival is poorer in patients with progressive stages of malnutrition post-pancreaticoduodenectomy in both immediate and long-term.