The dumping syndrome after pancreatoduodenectomy

Some patients have postoperative nutritional problems after a pancreatoduodenectomy. These problems have been attributed without objective evidence to the partial gastrectomy that is performed at the time of the pancreatoduodenectomy. The dumping syndrome has been implicated, and the results of this study determine, for the first time, the role of the dumping syndrome in pancreatic surgical procedures. Sixty-four dumping provocation tests have been performed upon patients with pancreatic disease or after pancreatic surgical treatment. Three patients had the dumping syndrome, and in eight, the result of the test was equivocal. Results of the present study demonstrate an incidence of dumping syndrome after pancreatoduodenectomy of 10 per cent; however, in none of these patients, was the dumping syndrome a significant problem. There was no instance of the dumping syndrome after pylorus-preserving or duodenum-preserving pancreatectomy. It is concluded that, contrary to previous assumptions, the dumping syndrome does not contribute to long term postoperative problems after pancreatic surgical procedures.