Early Administration of Pancrelipase Prevents Skeletal Muscle Mass Loss Following Distal Pancreatectomy.

Objectives: The clinical significance of early administration of pancrelipase after distal pancreatectomy (DP) has not been reported, and its effect on new-onset diabetes mellitus (DM) has not been clarified. This study aimed to investigate the effect of early administration of pancrelipase after DP on postoperative nutritional status, skeletal muscle mass, and new-onset DM.

Methods: We retrospectively reviewed the medical records of 76 patients who underwent DP. Delayed-release high-titer pancrelipase was administered daily, starting on postoperative day 3 (EP group). Postoperative nutritional status, skeletal muscle mass index (SMI), and new-onset DM were evaluated 6 months following DP. These factors were compared between the EP and control groups.

Results: Thirty-four patients (44.7%) were included in the EP group. Regarding the postoperative status 6 months after DP, the body mass index (BMI) was higher (P=0.004), hemoglobin A1c was higher (P=0.034), and SMI reduction ratio was lower (P=0.005) in the EP group than in the control group. However, the incidence of new-onset DM was similar between the two groups. After propensity score matching and inverse probability weighting analyses, the SMI reduction ratio was lower in the EP group (P=0.040 and P=0.003, respectively) than in the control group; however, no significant difference was observed in the incidence of new-onset DM and the hemoglobin A1c level.

Conclusions: Early administration of pancrelipase prevents loss of skeletal muscle mass after DP.