AI Article Synopsis
- Pancreaticoduodenectomy (PD) is a common surgery for treating pancreatic cancer, but it can lead to a condition called pancreatic exocrine insufficiency (PEI), which is often not diagnosed or treated properly.
- PEI can be very common after PD surgery, with some studies showing nearly everyone experiences it, especially patients with pancreatic cancer.
- The main treatment for PEI is replacing the pancreatic enzymes that are not produced enough, but more research is needed to find better ways to diagnose and manage this condition after surgery.
Article Abstract
Pancreaticoduodenectomy (PD) is the commonest procedure performed for pancreatic cancer. Pancreatic exocrine insufficiency (PEI) may be caused or exacerbated by surgery and remains underdiagnosed and undertreated. The aim of this review was to ascertain the incidence of PEI, its consequences and management in the setting of PD for indications other than chronic pancreatitis. A literature search of databases (MEDLINE, EMBASE, Cochrane and Scopus) was carried out with the MeSH terms "pancreatic exocrine insufficiency" and "Pancreaticoduodenectomy". Studies that analysed PEI and its complications in the setting of PD for malignant and benign disease were included. Studies reporting PEI in the setting of PD for chronic pancreatitis, conference abstracts and reviews were excluded. The incidence of PEI approached 100% following PD in some series. The pre-operative incidence varied depending on the characteristics of the patient cohort and it was higher (46%-93%) in series where pancreatic cancer was the predominant indication for surgery. Variability was also recorded with regards to the method used for the diagnosis and evaluation of pancreatic function and malabsorption. Pancreatic enzyme replacement therapy is the mainstay of the management. PEI is common and remains undertreated after PD. Future studies are required for the identification of a well-tolerated, reliable and reproducible diagnostic test in this setting.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156847 | PMC |
| http://dx.doi.org/10.4291/wjgp.v11.i2.20 | DOI Listing |
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