AI Article Synopsis
- Patients who undergo pancreatectomy face risks of pancreatic exocrine insufficiency and malnutrition, with this study exploring the complications and risk factors associated with these outcomes.
- The study involved assessing nutritional status, pancreatic structure, and exocrine function in 70 patients undergoing different types of pancreatic surgeries, revealing significant weight and muscle loss post-surgery.
- Findings indicated that over half of the patients experienced varying degrees of pancreatic exocrine insufficiency and emphasized specific risk factors like pre-existing pancreatic ductal adenocarcinoma and low preoperative body mass index that contributed to postoperative malnutrition.
Article Abstract
Background: Patients undergoing pancreatectomy are at risk for pancreatic exocrine insufficiency and malnutrition. However, the incidence of these complications and the associated risk factors have not been sufficiently examined. This study aimed to investigate the changes in pancreatic morphology, pancreatic exocrine function, and long-term nutritional status after pancreatectomy.
Methods: We assessed the nutritional status, pancreatic morphologic parameters, and pancreatic exocrine function in patients undergoing pancreaticoduodenectomy and distal pancreatectomy. Nutritional status was evaluated on the basis of body weight change, body mass index, and skeletal muscle mass. Pancreatic parenchymal texture at the time of surgery, remnant volume of the pancreatic parenchyma, and diameter of the pancreatic duct were measured. Exocrine function was measured using the N-benzoyl-L-tyrosyl-p-aminobenzoic acid excretion test and the clinical signs of steatorrhea and nonalcoholic steatohepatitis. We then investigated potential causal relationships.
Results: Seventy patients were included in the study. Moderate and severe malnutrition were diagnosed in 19 (27%) and 15 patients (21%), respectively. Most patients with malnutrition before surgery were also found to be malnourished postoperatively. Body weight and skeletal muscle mass decreased after pancreatectomy in most patients, even in the longer term. Subclinical and clinical pancreatic exocrine insufficiency was found in 36 (51%) and 25 patients (36%), respectively, and pancreatic ductal adenocarcinoma, pancreaticoduodenectomy, dilated pancreatic duct, low preoperative body mass index, and pancreatic exocrine insufficiency grade were found to contribute to postoperative malnutrition.
Conclusion: Pancreatic ductal adenocarcinoma, dilated pancreatic duct, pancreaticoduodenectomy, low preoperative body mass index, and pancreatic exocrine insufficiency were risk factors for postoperative malnutrition.
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| http://dx.doi.org/10.1016/j.surg.2024.05.046 | DOI Listing |
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