Pancreatic exocrine insufficiency following pancreatic resection

Phillips, Mary

doi:10.1016/j.pan.2015.06.003

Cited by 79 publications

(53 citation statements)

References 51 publications

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“…In one study, the prevalence of EPI in PDAC prior to surgical resection was approximately 42–45% compared to 12–80% after distal or central pancreatectomy and 56–98% after pancreaticoduodenectomy. 10 In the current cohort, the frequency of PERT usage was much higher in the group who underwent surgical intervention (56.1% vs. 21.9%, P < 0.01), which likely reflects an increased awareness of EPI in this disease subgroup. Other groups have also shown that even though patients may be placed on PERT postoperatively, they are often provided with a suboptimal dosage.…”

Section: Discussionmentioning

confidence: 55%

Predictors of Pancreatic Cancer–Associated Weight Loss and Nutritional Interventions

et al. 2017

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Objectives Pancreatic ductal adenocarcinoma (PDAC) is often accompanied by weight loss. We sought to characterize factors associated with weight loss and observed nutritional interventions, as well as define the effect of weight loss on survival. Methods Consecutive subjects diagnosed with PDAC (n = 123) were retrospectively evaluated. Univariate analysis was used to compare subjects with and without substantial (>5%) weight loss. Multivariate logistic regression was performed to identify factors associated with weight loss, and survival analyses were performed Kaplan-Meier curves and Cox survival models. Results Substantial weight loss at diagnosis was present in 71.5% of subjects, and was independently associated with higher baseline body mass index, longer symptom duration, and increased tumor size. Recommendations for nutrition consultation and pancreatic enzyme replacement therapy occurred in 27.6% and 36.9% of subjects, respectively. Weight loss (>5%) was not associated with worse survival on multivariate analysis (hazard ratio (HR) 1.32, 95% CI, 0.76–2.30), unless a higher threshold (>10%) was used (HR 1.77, 95% CI, 1.09–2.87). Conclusions Despite the high prevalence of weight loss at PDAC diagnosis, there are low observed rates of nutritional interventions. Weight loss based on current criteria for cancer cachexia is not associated with poor survival in PDAC.

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Section: Discussionmentioning

confidence: 55%

Predictors of Pancreatic Cancer–Associated Weight Loss and Nutritional Interventions

et al. 2017

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“…Dietitians can provide essential dietary suggestions, identify PEI, and provide recommendations for oral nutritional supplementation and specialized nutrition support . Dietitians may also provide more detailed advice on diet and pancreatic enzyme supplementation for management of symptoms of PEI .…”

Section: Intervention For Pawlmentioning

confidence: 99%

Pancreas Cancer-Associated Weight Loss

et al. 2018

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“…13,20,21 Not only are these required for nutrient breakdown and absorption, but these structures also secrete gastrointestinal hormones influencing gut motility, so disruption in their hormone production can cause gastrointestinal asynchrony. 3,20,22 Much of the absorption of vitamins and minerals (most notably iron and calcium) is in this first part of the small intestine. 21,23 Though rarely seen, partial gastrectomy as part of a standard PD increases the risk of vitamin B12 deficiency due to reduction in intrinsic factor production.…”

Section: Anatomic Influencesmentioning

confidence: 99%

“…2 Long-term sequelae are expected due to major alterations in intestinal anatomy, including malabsorption (vitamin and mineral deficiencies or osteoporosis), and metabolic derangements, including hepatic dysfunction and diabetes. 3 Additionally, there may be metabolic consequences of chemotherapy leading to electrolyte amnormalities. 4,5 This year, approximately 53,670 people in the United States will be diagnosed with pancreatic cancer, and 43,090 will die of it.…”

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confidence: 99%

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Petzel

Hoffman

2017

Nut in Clin Prac

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With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease. Beyond causing additional medical problems, each of these can have significant effects on quality of life and functional status. The potential mechanisms, diagnosis criteria, and potential treatments of these conditions are described. Overall, little literature exists to fully describe the effects of these comorbidities, and even less is able to guide effective treatments for this population. Clinicians caring for these patients should begin incorporating goals for promotion of long-term health and reduction of these known and reported comorbidities in patients who have undergone pancreatic surgery. Treatment plans in this population remain understudied, and clinicians may need to consider recommendations for similar disease states when developing interventions for these patients.

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Pancreatic exocrine insufficiency following pancreatic resection

Cited by 79 publications

References 51 publications

Predictors of Pancreatic Cancer–Associated Weight Loss and Nutritional Interventions

Predictors of Pancreatic Cancer–Associated Weight Loss and Nutritional Interventions

Pancreas Cancer-Associated Weight Loss

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

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