Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy

Hata, Tatsuo; Ishida, Masaharu; Motoi, Fuyuhiko; Sakata, Naoaki; Yoshimatsu, Gumpei; Naitoh, Takeshi; Katayose, Yu; Egawa, Shinichi; Unno, Michiaki

doi:10.1097/mpa.0000000000000462

Cited by 32 publications

(33 citation statements)

References 39 publications

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“…Outcomes related to exocrine insufficiency were reported in 15 studies, including 495 patients, during a median follow‐up of 19·6 (range 1·5–96·0) months ( Table ). Exocrine insufficiency‐related symptoms were reported by 43·5 per cent (143 of 329 patients) during a median follow‐up of 15·9 (1·5–96·0) months.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies investigated laboratory tests to assess patients' nutritional status. Serum nutritional markers decreased in the first 1–6 months after total pancreatectomy, but had stabilized or normalized by 12 months after surgery.…”

Section: Resultsmentioning

confidence: 99%

“…The wide range of incidence of diarrhoea (0–64 per cent) suggests that management is difficult, but achievable. In the literature, the extent of resection is mentioned as a contributing cause of diarrhoea. Extended resection could lead to autonomic denervation and therefore impaired bowel control, explaining the difference in severity of diarrhoea between benign and malignant indications.…”

Section: Discussionmentioning

confidence: 99%

“…Periampullary cancer (3) NET (6) Other (5) Serous cystic tumours (1) Crippa et al 21 † 65 PDAC (19) IPMN (6) SCA (1) 1 (2) Renal mets (6) Invasive IPMN (25) NET (6) Periampullary cancer (1) Crippa et al 22 23 77 PDAC (50) IPMN (15) SCA (1) 4 (5) § Renal mets (1) Invasive IPMN (2) NET (4) Fujino et al 24 36 PDAC (17) NET (2) Acute pancreatitis (1) 1 (3) Mets (1) Invasive IPMN (14) Hartwig et al 6 434 PDAC (289) IPMN (44) SCN (4) 4 (0⋅9) § Other (4) Invasive IPMN (31) NET (28) Adenosquamous carcinoma (8) Acinar cell carcinoma (4) Other (18) Hata et al 25 43 PDAC (21) IPMN (11) Solid pseudopapillary neoplasm (1)…”

Section: Surgical Detailsmentioning

confidence: 99%

“…In that study, pancreatic enzyme dosage was based on patients' stool consistency, BMI, serum albumin and signs of liver steatosis on CT, achieving a stabile BMI and no diarrhoea. Several studies 6,18,24,25,31,33,34 investigated laboratory tests to assess patients' nutritional status. Serum nutritional markers decreased in the first 1-6 months after total pancreatectomy, but had stabilized or normalized by 12 months after surgery 6,24,31,33,34 .…”

Section: Hyperglycaemia (0)mentioning

confidence: 99%

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Systematic review of functional outcome and quality of life after total pancreatectomy

Scholten¹,

Stoop²,

Chiaro

et al. 2019

British Journal of Surgery

101

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BackgroundSurgeons have traditionally been reluctant to perform total pancreatectomy because of concerns for brittle diabetes and poor quality of life (QoL). Several recent studies have suggested that outcomes following total pancreatectomy have improved, but a systematic review is lacking.MethodsA systematic review was undertaken of studies reporting on outcomes after total pancreatectomy for all indications, except chronic pancreatitis. PubMed, EMBASE (Ovid), and Cochrane Library were searched (2005–2018). Endpoints included functional outcome and QoL.ResultsA total of 21 studies, including 1536 patients, fulfilled the eligibility criteria. During a median follow‐up of 20·8 (range 1·5–96·0) months, 18·6 per cent (45 of 242 patients) were readmitted for endocrine‐related morbidity, with associated mortality in 1·6 per cent (6 of 365 patients). No diabetes‐related mortality was reported in studies including only patients treated after 2005. Symptoms related to exocrine insufficiency were reported by 43·5 per cent (143 of 329 patients) during a median follow‐up of 15·9 (1·5–96·0) months. Overall QoL, reported by 102 patients with a median follow‐up of 28·6 (6·0–66·0) months, using the EORTC QLQ‐C30 questionnaire, showed a moderately reduced summary score of 76 per cent, compared with a general population score of 86 per cent (P = 0·004).ConclusionOverall QoL after total pancreatectomy is affected adversely, in particular by the considerable impact of diarrhoea that requires better treatment. There is also room for improvement in the management of diabetes after total pancreatectomy, particularly with regards to prevention of diabetes‐related morbidity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%