The impact of pancreaticoduodenectomy on endocrine and exocrine pancreatic function: A prospective cohort study based on pre- and postoperative function tests

Roeyen, Geert; Jansen, M.; Hartman, V.; Chapelle, T.; Bracke, B.; Ysebaert, Dirk; Block, Christophe De

doi:10.1016/j.pan.2017.09.004

Cited by 22 publications

(9 citation statements)

References 31 publications

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“…A Belgian prospective cohort study in patients who had to undergo PD for an oncological indication reported a PEI prevalence of 20% pre-operatively and 64.1% post-operatively. 30 Results from a not-yet published sub-analysis that took only pancreatic adenocarcinoma patients into account ( n = 159) showed a PEI prevalence of 26.6% before PD and 78.1% after PD. In the case of DP ( n = 39), the prevalence of PEI was 15% pre-operatively and 10% post-operatively.…”

Section: Prevalence Of Pei In Pcmentioning

confidence: 96%

Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer

et al. 2022

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Pancreatic exocrine insufficiency (PEI) is a common condition in patients with pancreatic cancer (PC). PEI can be due to the tumor, which, if located in the head, causes obstruction of the pancreatic duct with subsequent atrophy of the pancreatic parenchyma, or it can be the consequence of pancreatic surgical resection. The standard treatment of PEI is pancreatic enzyme replacement therapy (PERT). Clinical data to support the use of PERT in PC are however limited. There are very few randomized clinical trials that evaluated PERT in PC. Most data come from observational studies. Despite this limited clinical evidence, PERT treatment for PEI is an essential part of supportive therapy to ensure optimal nutritional status in PC patients who will receive surgery, neoadjuvant/adjuvant or palliative treatment. The objective of this review is to increase the awareness about PEI in PC patients and to provide expert recommendations on the use of PERT in resected, borderline resectable and unresectable patients, based on clinical experience and literature review.

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Section: Prevalence Of Pei In Pcmentioning

confidence: 96%

Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer

et al. 2022

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“…In 2017, Roeyen et al published a prospective study evaluating pancreatic function in 78 patients after pancreatoduodenectomy using the 13 C-labeled mixed-triglyceride breath test preoperatively and postoperatively. The results revealed that 64.1% of the patients required postoperative enzyme replacement therapy [29]. In another study, Lim et al observed exocrine and endocrine insufficiency in a prospective study with 227 patients who underwent pancreatic surgery.…”

Section: Pancreatic Resectionsmentioning

confidence: 97%

Causes of Exocrine Pancreatic Insufficiency Other Than Chronic Pancreatitis

Kunovský

Dítě

Jabandžiev

et al. 2021

JCM

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Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malnutrition, results from primary pancreatic disease or is secondary to impaired exocrine pancreatic function. Although chronic pancreatitis is the most common cause of EPI, several additional causes exist. These include pancreatic tumors, pancreatic resection procedures, and cystic fibrosis. Other diseases and conditions, such as diabetes mellitus, celiac disease, inflammatory bowel disease, and advanced patient age, have also been shown to be associated with EPI, but the exact etiology of EPI has not been clearly elucidated in these cases. The causes of EPI can be divided into loss of pancreatic parenchyma, inhibition or inactivation of pancreatic secretion, and postcibal pancreatic asynchrony. Pancreatic enzyme replacement therapy (PERT) is indicated for the conditions described above presenting with clinically clear steatorrhea, weight loss, or symptoms related to maldigestion and malabsorption. This review summarizes the current literature concerning those etiologies of EPI less common than chronic pancreatitis, the pathophysiology of the mechanisms of EPI associated with each diagnosis, and treatment recommendations.

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“…NOD has also been described in 15%-20% of patients[ 143 , 145 , 146 ] after surgery. One study reported deterioration of the glycaemic control in up to 40% post-operatively[ 147 ],when formal tests like OGTT and i.v. glucagon stimulation test were used.…”

Section: Effect Of Pc Treatment On Diabetesmentioning

confidence: 99%

Diabetes and pancreatic cancer: Exploring the two-way traffic

Roy¹,

Sahoo²,

Kamalanathan³

et al. 2021

WJG

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Pancreatic cancer (PC) is often associated with a poor prognosis. Long-standing diabetes mellitus is considered as an important risk factor for its development. This risk can be modified by the use of certain antidiabetic medications. On the other hand, new-onset diabetes can signal towards an underlying PC in the elderly population. Recently, several attempts have been made to develop an effective clinical tool for PC screening using a combination of history of new-onset diabetes and several other clinical and biochemical markers. On the contrary, diabetes affects the survival after treatment for PC. We describe this intimate and complex two-way relationship of diabetes and PC in this review by exploring the underlying pathogenesis.

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The impact of pancreaticoduodenectomy on endocrine and exocrine pancreatic function: A prospective cohort study based on pre- and postoperative function tests

Abstract: Although deterioration of endocrine function was expected after pancreatic resection, improvement is frequently observed in patients with newly diagnosed diabetes. Exocrine function deteriorates after pancreaticoduodenectomy.

Cited by 22 publications

References 31 publications

Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer

Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer

Causes of Exocrine Pancreatic Insufficiency Other Than Chronic Pancreatitis

Diabetes and pancreatic cancer: Exploring the two-way traffic

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