Digestive function after radical pancreaticoduodenectomy

Fish, Jay C.; Smith, Lindsay B.; Williams, Roger D.

doi:10.1016/0002-9610(69)90283-9

Cited by 81 publications

(22 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early studies showed that 50 19 to 25% Similarly to our results, some authors did not point any differences between the SPD and PPPD patients' weight 4,5 .…”

Section: Discussionsupporting

confidence: 88%

Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy: influence of pylorus preservation procedure

Muniz¹,

Braga²,

Kemp³

et al. 2012

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE:To evaluate the nutritional status of patients in the late postoperative period of pancreaticoduodenectomy (PD) and compare the long-term outcome according to pylorus-preserving (PPPD) or the standard technique (SPD) in which the pylorus is resected. METHODS: This prospective study was conducted twelve months prior or more in patients who had underwent PD (PD Group, n=15) and health volunteers (Control Group, n=15). At a post hoc analysis, the PD Group was divided in PPPD Subgroup (n=9) and SPD Subgroup (n=6), according to the PD techniques. Gastrointestinal complaints and nutritional status were evaluated, apart from a biochemical assessment; Student t-test or Mann-Whitney test were used. RESULTS:The patients recovered their body weight and the gastrointestinal complaints were uncommon. The PD Group showed higher energy and protein intake even though BMI was lower than in Control Group. There were no differences in laboratorial data, except for higher glycemia, serum alkaline phosfatase and C-reactive protein in PD Group. There was no difference in the various parameters evaluated when the Subgroups (PPPD and SPD) were compared. CONCLUSION: For long-term pancreaticoduodenectomy, the gastrointestinal symptoms are minimal and the patients had the clinical and nutritional status preserved, regardless of pylorus preservation. Key words: Pancreaticoduodenectomy. Nutritional Status. Anthropometry. Blood Proteins. RESUMO OBJETIVO:Avaliar o estado nutricional de pacientes em pós-operatório tardio de pancreaticoduodenectomia (PD) e comparar a evolução de acordo com a preservação de piloro (PPPD) ou pela técnica padrão com ressecção do piloro (SPD). MÉTODOS: O estudo prospectivo foi conduzido com pacientes submetidos à PD após período mínimo de 12 meses (Grupo PD, n=15) e voluntários saudáveis (Grupo Controle, n=15). Numa análise posterior, o Grupo PD foi dividido em Subgrupo PPPD (n=9) e Subgrupo SPD (n=6), de acordo com a técnica de PD. Foram avaliadas as queixas digestivas, o estado nutricional e dados bioquímicos; a análise estatística foi realizada por meio do teste t-Student ou Mann-Whitney. RESULTADOS: Os pacientes recuperaram o estado nutricional e as queixas gastrointestinais foram incomuns. A ingestão protéica e energética foi maior no Grupo PD, apesar do menor IMC. Não houve diferenças em relação aos exames laboratoriais, exceto pelos maiores níveis de glicemia, fosfatase alcalina sérica e proteína C-reativa no Grupo PD. Quando os Subgrupos PPPD e SPD foram comparados, não houve diferenças nos diversos parâmetros analisados. CONCLUSÃO: No pós-operatório tardio de pancreaticoduodenectomia, os sintomas gastrointestinais são mínimos e o estado clínico e nutricional é adequado, independente da preservação do piloro. Descritores: Pancreaticoduodenectomia. Estado Nutricional. Antropometria. Proteínas Sanguíneas.Muniz CK et al.

show abstract

“…Early studies showed that 50 19 to 25% Similarly to our results, some authors did not point any differences between the SPD and PPPD patients' weight 4,5 .…”

Section: Discussionsupporting

confidence: 88%

Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy: influence of pylorus preservation procedure

Muniz¹,

Braga²,

Kemp³

et al. 2012

Acta Cir. Bras.

View full text Add to dashboard Cite

show abstract

“…The extensive resection of organs and reconstruction of the alimentary tract associated with PD lead to inhibition of pancreatic function in most patients. 1 Since impaired exocrine pancreatic function can often lead to malnutrition, maldigestion, and steatorrhea, evaluation of postoperative exocrine pancreatic function is important to ensure proper nutritional management of patients after PD and to quantify the effects of pancreatic enzyme supplementation.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Exocrine Pancreatic Insufficiency After Pancreatoduodenectomy with Pancreaticogastrostomy

Nakamura

Murakami

Uemura

et al. 2009

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

show abstract

“…These negatives have included the significant incidence of marginal ulcers involving the gastrojejunostomy anastomosis, diarrhea, steatorrhea, dumping, abdominal pain, protein malnutrition, weight loss, and poor quality of life. Some of these issues were first identified by Fish et al21 Detractors of the standard operation have focused on the observation of Fish et al21 that “all of the patients lost weight (10–40 pounds) after the operative procedure” (six patients). What many readers of this quote may have failed to appreciate is that in the article, Fish et al go on to state that, after the institution of pancreatic enzyme replacement, “three were able to regain their normal weight”, and “all three of these patients resumed their previous occupations”.…”

Section: Pylorus‐preserving Pancreaticoduodenectomy Versus Standard Pmentioning

confidence: 99%

Pylorus-preserving pancreaticoduodenectomy for pancreatic and peripancreatic malignancies: A 1996 perspective

Frey

1997

J Hep Bil Pancr Surg

View full text Add to dashboard Cite

Pylorus-preserving pancreaticoduodenectomy, based on review of the literature, conveys little, if any, measurable benefit over the standard operation with regard to nutrition and metabolism. Some of the benefits attributed to pylorus preservation by Traverso may be due instead to his use of a duct-to-mucosa pancreaticojejunostomy anastomosis which preserves pancreatic function. Comparisons of the standard and pylorus-preserving operation in regard to metabolic, nutritional, and postgstrectomy syndromes are hindered by a lack of uniformity from one report to another regarding the type of pancreaticojejunostomy anastomosis performed, the amount of stomach resected, whether vagotomy was or was not performed, and whether a Billroth I ,br II gastrojejunostomy or duodenojejunostomy was performed. Pyloruspreserving pancreaticoduodenectomy can be used safely in the management of about 85% of patients with pancreatic and distal common bile duct cancer and in 95% of those with ampullary cancer. The standard operation should be used in the presence of any sign of tumor infiltration of the duodenal bulb or peripyloric lymph nodes. Japanese surgeons have emphasized the utility of employing the Billroth I rather than Billroth If anastomosis after pancreaticoduodenectomy, as it provides access to visualize endoscopically the pancreaticojejunostomy and choledochojejunostomy anastomosis.

show abstract

Digestive function after radical pancreaticoduodenectomy

Cited by 81 publications

References 9 publications

Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy: influence of pylorus preservation procedure

Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy: influence of pylorus preservation procedure

Predictive Factors for Exocrine Pancreatic Insufficiency After Pancreatoduodenectomy with Pancreaticogastrostomy

Pylorus-preserving pancreaticoduodenectomy for pancreatic and peripancreatic malignancies: A 1996 perspective

Contact Info

Product

Resources

About