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Indian Journal of Surgical Oncology
Published in: Indian Journal of Surgical Oncology 2/2019

01-06-2019 | Pancreaticojejunostomy | Review Article

Assessment of Exocrine Function of Pancreas Following Pancreaticoduodenectomy

Authors: Kiran Thogari, Mallika Tewari, S. K. Shukla, S. P. Mishra, H. S. Shukla

Published in: Indian Journal of Surgical Oncology | Issue 2/2019

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Abstract

Pancreatic exocrine insufficiency (PEI) is a common long-term complication after pancreaticoduodenectomy (PD) and is observed in 23–80% of patients. As the postoperative mortality after PD has substantially decreased, it warrants more attention on the diagnosis and treatment of functional long-term consequences after PD. These include PEI and endocrine insufficiency that can result in significant nutritional impairment and often adversely impacts quality of life (QOL) of the patient. A PubMed search was performed for articles using key words “pancreatic exocrine insufficiency”; “pancreaticoduodenectomy”; “quality of life after pancreaticoduodenectomy”; “stool elastase”; “direct, indirect tests for pancreatic exocrine insufficiency”; “pancreatic enzyme replacement therapy.” Relevant studies were shortlisted and analyzed. This review summarizes relevant studies addressing PEI following PD. We also discuss functional changes after PD, risk factors and predictive factors for postoperative PEI, clinical symptoms, direct and indirect tests for estimation of PEI, pancreatic enzyme replacement therapy (PERT), and QOL after pancreatic resection for malignancy. It was found that significant PEI occurs in most patients following PD. Fecal elastase 1 is an easy indirect test and should be performed routinely in both symptomatic and asymptomatic patients after PD. PERT should be considered in every patient after PD with the aim to improve the QOL and perhaps even their long time survival.
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Metadata
Title
Assessment of Exocrine Function of Pancreas Following Pancreaticoduodenectomy
Authors
Kiran Thogari
Mallika Tewari
S. K. Shukla
S. P. Mishra
H. S. Shukla
Publication date
01-06-2019
Publisher
Springer India
Published in
Indian Journal of Surgical Oncology / Issue 2/2019
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-019-00901-0

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