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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Functional sequelae after pancreatic resection for cancer.

Andrea Mulliri1, Michael Joubert2, Marie-Astrid Piquet3

  • 1Digestive Surgery Department, University Hospital Center of Caen, Normandie Université, UNICAEN, 14000 Caen, France; Anticipe' U1086 Inserm-UCBN, 'Cancers & Preventions', Registre spécialisé des Tumeurs Digestives du Calvados, Team Labelled 'League Against Cancer', UNICAEN, Normandie Université, 14000 Caen, France.

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|October 2, 2023
PubMed
Summary

Pancreatic cancer surgery leads to functional issues like exocrine pancreatic insufficiency and delayed gastric emptying. Nutritional support and enzyme therapy are key to managing these common post-operative sequelae.

Keywords:
Endocrine pancreatic insufficiencyExocrine pancreatic insufficiencyMalnutritionPancreatic resectionPancreatoduodenectomy

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Area of Science:

  • Gastroenterology and Surgical Oncology
  • Patient Outcomes and Management

Background:

  • Pancreatic cancer surgery has improved, shifting focus to managing post-operative functional and nutritional issues.
  • Functional and nutritional sequelae are significant concerns for patients undergoing pancreatic resection.

Purpose of the Study:

  • To review the prevalence and severity of functional sequelae after pancreatic resection for cancer and pre-cancerous lesions.
  • To document therapeutic management strategies for identified sequelae.

Main Methods:

  • Literature review focusing on functional sequelae (ExPI, EnPI, DGE) and nutritional deficiencies.
  • Analysis of sequelae prevalence based on pancreatic resection type (PD, DP).

Main Results:

  • Exocrine pancreatic insufficiency (ExPI) affects ~33% of patients one year post-surgery.
  • Endocrine pancreatic insufficiency (EnPI) occurs in ~20% after PD and ~33% after DP.
  • Delayed gastric emptying (DGE) impacts 10-45% after PD and ~8% after DP.

Conclusions:

  • Pancreatic surgery frequently results in ExPI, EnPI, and DGE, necessitating tailored management.
  • Nutritional support, including enzyme replacement and vitamin supplementation, is crucial.
  • Understanding these sequelae improves comprehensive patient care post-pancreatic surgery.