Significance of administering postoperative pancreatic enzyme replacement therapy for fat digestion and absorption functions in patients who underwent initial total pancreatectomy.
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引用次数: 0
Abstract
Objectives: To evaluate the effects of postoperative pancreatic enzyme replacement therapy on fat digestion and absorption in patients following initial total pancreatectomy.
Methods: Data were retrospectively collected from patients who underwent initial total pancreatectomy at our department between 2012 and 2020. Fat digestion, absorption functions, serum nutritional markers, HbA1c levels, and hepatic steatosis before and after the initial total pancreatectomy were evaluated. The rate of change in these parameters pre- and 1-year postoperatively were compared between patients with initial total pancreatectomy and pancreaticoduodenectomy. Patients underwent the 13C-labeled mixed triglyceride breath test to evaluate fat digestion and absorption functions. Hepatic steatosis was assessed using computed tomography.
Results: Of 17 consecutive patients who underwent initial total pancreatectomy, 12 were men, and the median age was 70 years. All 17 patients received 1800 mg pancrelipase when food intake was resumed after surgery. The pre- and 1-year postoperative median % dose 13C cum 7 h (%), serum nutritional markers, HbA1c levels, and liver computed tomography findings did not differ significantly. Two patients had nonalcoholic fatty liver disease after surgery, without serious disease progression. In total, 48 patients who underwent pancreaticoduodenectomy were found eligible. The median change in % dose 13C cum 7 h (%), serum nutritional markers, HbA1c levels, and liver computed tomography findings pre and 1-year postoperatively showed no significant differences between the initial total pancreatectomy and pancreaticoduodenectomy groups.
Conclusions: High-dose pancreatic enzyme replacement therapy after initial total pancreatectomy might maintain fat digestion and absorption functions and nutritional status and prevent hepatic steatosis.
期刊介绍：
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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