Pancreatic exocrine insufficiency following pancreatoduodenectomy: A prospective bi-center study
Background/objectivesPancreatic exocrine insufficiency (PEI) is a common complication following pancreatoduodenectomy (PD) leading to malnutrition. The course of PEI and related symptoms and vitamin deficiencies is unknown. This study aimed to assess the (long-term) incidence of PEI and vitamin defi...
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Published in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 22; no. 7; pp. 1020 - 1027 |
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Main Authors: | , , , , , , , , , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Philadelphia
Elsevier Limited
01-11-2022
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Subjects: | |
Online Access: | Get full text |
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Summary: | Background/objectivesPancreatic exocrine insufficiency (PEI) is a common complication following pancreatoduodenectomy (PD) leading to malnutrition. The course of PEI and related symptoms and vitamin deficiencies is unknown. This study aimed to assess the (long-term) incidence of PEI and vitamin deficiencies after PD.MethodsA bi-centre prospective observational cohort study was performed, including patients who underwent PD for mainly pancreatic and periampullary (pre)malignancies (2014–2018). Two cohorts were formed to evaluate short and long-term results. Patients were followed for 18 months and clinical symptoms were evaluated by questionnaire. PEI was based on faecal elastase-1 (FE-1) levels and/or clinical symptoms.ResultsIn total, 95 patients were included. After three months, all but three patients had developed PEI and 27/29 (93%) patients of whom stool samples were available showed abnormal FE-1 levels, which did not improve during follow-up. After six months, all patients had developed PEI. During follow-up, symptoms resolved in 35%–70% of patients. Vitamin D and K deficiencies were observed in 48%–79% of patients, depending on the moment of follow-up; 0%–50% of the patients with deficiencies received vitamin supplementation.DiscussionThis prospective study found a high incidence of PEI after PD with persisting symptoms in one-to two thirds of all patients. Limited attention was paid to vitamin deficiencies. Improved screening and treatment strategies for PEI and vitamins need to be designed. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1424-3903 1424-3911 |
DOI: | 10.1016/j.pan.2022.08.002 |