Nutritional Assessment in Patients with Double Malignant Obstruction: Biliary and Duodenal

Mohamed Acharki; Imane Boussenna; Chaymaa Khyat; Nawal Kabbaj; Abdellatif Bour

doi:10.23751/pn.2026.17910

Nutritional Assessment in Patients with Double Malignant Obstruction: Biliary and Duodenal

Authors

Mohamed Acharki Department of Biology, Laboratory of Biology and Health, Team of Nutrition, Food and Health Sciences (ENSAS) University Ibn Tofail, Kenitra, Morocco; Department of EFD-HGE, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco. https://orcid.org/0009-0001-5764-1859
Imane Boussenna Department of Biology, Laboratory of Biology and Health, Team of Nutrition, Food and Health Sciences (ENSAS) University Ibn Tofail, Kenitra. https://orcid.org/0000-0003-0291-6111
Chaymaa Khyat Department of EFD-HGE, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco https://orcid.org/0009-0003-5333-5875
Nawal Kabbaj Department of EFD-HGE, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco https://orcid.org/0009-0002-4741-6479
Abdellatif Bour Department of Biology, Laboratory of Biology and Health, Team of Nutrition, Food and Health Sciences (ENSAS) University Ibn Tofail, Kenitra, Morocco https://orcid.org/0000-0001-7470-8878

Keywords:

Duodenal strictures, Biliary strictures, Nutritional status, Undernutrition, Assessment

Abstract

Background and aim: Biliary tract and pancreatic cancers carry a poor prognosis due to their rapid progression and frequent complications, such as malignant biliary and duodenal stenosis. The aim of this study was to evaluate the nutritional status of patients with simultaneous biliary and duodenal obstruction and its negative impact on their general condition and quality of life. Methods: This retrospective analysis included 200 patients hospitalized at Ibn Sina University Hospital in Rabat for malignant stenosis. Among them, 110 had isolated biliary stenosis (Group 1), while 90 presented with both biliary and duodenal stenosis (Group 2). Data collected included anthropometric measurements (weight, height, BMI), biological parameters (albumin, bilirubin, CRP), vomiting frequency, and Nutritional Risk Index (NRI). Results: The study population consisted of 54.5% men and 45.5% women, with a mean age of 56.7 years. Patients in Group 2 had significantly lower weight (47.4 ± 5.4 kg) and BMI (15.9 ± 2.0 kg/m²) compared with Group 1 (57.4 ± 9.3 kg and 20.0 ± 3.3 kg/m²; p = 0.000). Biologically, Group 2 showed more pronounced hypoalbuminemia (26.1 g/L vs 29.3 g/L) and higher bilirubin and CRP levels. Severe malnutrition was observed in 100% of Group 2 versus 76.3% of Group 1. Daily vomiting was also more frequent in Group 2 (84.4% vs 16.3%). Conclusions: These findings confirm the critical impact of double malignant obstruction on nutritional status and quality of life, underlining the importance of early nutritional assessment, timely intervention, and a multidisciplinary palliative approach to improve outcomes in this vulnerable population.

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