Article ; Online: Pancreatic exocrine insufficiency following pancreatoduodenectomy: A prospective bi-center study.
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.
2022 Volume 22, Issue 7, Page(s) 1020–1027
Abstract: Background/objectives: Pancreatic 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 ... ...
| Abstract | Background/objectives: Pancreatic 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. Methods: A 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. Results: In 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. Discussion: This 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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| MeSH term(s) | Humans ; Pancreaticoduodenectomy/adverse effects ; Prospective Studies ; Exocrine Pancreatic Insufficiency/epidemiology ; Exocrine Pancreatic Insufficiency/etiology ; Exocrine Pancreatic Insufficiency/diagnosis ; Pancreas ; Vitamin A | |||||
| Chemical Substances | Vitamin A (11103-57-4) | |||||
| Language | English | |||||
| Publishing date | 2022-08-05 | |||||
| Publishing country | Switzerland | |||||
| Document type | Observational Study ; Journal Article | |||||
| ZDB-ID | 2056680-3 | |||||
| ISSN | 1424-3911 ; 1424-3903 | |||||
| ISSN (online) | 1424-3911 | |||||
| ISSN | 1424-3903 | |||||
| DOI | 10.1016/j.pan.2022.08.002 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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