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[Digestive and endocrine functions after partial duodeno-pancreatectomy]
Deutsche Medizinische Wochenschrift (1946)
|January 31, 1975
Summary
Pancreaticoduodenectomy significantly impairs digestive and endocrine functions, leading to malabsorption and asymptomatic diabetes mellitus in most patients. Post-operative assessment revealed substantial pancreatic function loss.
Area of Science:
- Gastroenterology
- Endocrinology
- Surgical Oncology
Background:
- Pancreaticoduodenectomy (Whipple procedure) is a major surgery for pancreatic head and periampullary tumors.
- Assessing the impact on digestive and endocrine functions is crucial for patient management.
Purpose of the Study:
- To evaluate the digestive and endocrine functional consequences of pancreaticoduodenectomy.
- To assess pancreatic exocrine and endocrine insufficiency post-surgery.
Main Methods:
- Performed pancreaticoduodenectomy on 11 patients.
- Assessed fecal fat, 14C-exhalation, stool chymotrypsin, and oral glucose tolerance tests with insulin levels.
- Measured serum gastrin levels.
Main Results:
- All patients showed abnormal fecal fat, indicating severe pancreatic exocrine insufficiency (approx. 90% loss).
- Most patients developed asymptomatic diabetes mellitus, with two requiring insulin post-operatively.
- Decreased serum gastrin levels suggested both gastric and extragastric gastrin sources.
Conclusions:
- Pancreaticoduodenectomy results in significant exocrine and endocrine pancreatic insufficiency.
- Post-surgical diabetes mellitus is common, necessitating careful monitoring and management.
- Gastrin level changes indicate complex hormonal regulation after the procedure.