Assistance nutritionnelle parentérale et entérale (hors immunonutrition)

The surgeon plays a key role in the perioperative nutritional care in patients undergoing elective major digestive surgery; therefore, he has to be able to anticipate needs and to implement corrective measures according to recommendations. Pre- and postoperative enteral feeding is preferred. In patients without obvious undernutrition, postoperative nutritional support has to be initiated if patients cannot maintain oral intake above 60 % of recommended intake for more than 7 days, and it has to be programmed if it is anticipated that the patient will be unable to eat for more than 7 days. Preoperative and postoperative nutritional support has to be offer in malnourished patients (grades 3 and 4).