Management of Pancreatic Exocrine Insufficiency

Powell‐Brett, Sarah; Chinuck, R.S.; Roberts, Keith

doi:10.1007/978-3-030-53786-9_43

Cited by 2 publications

(1 citation statement)

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“…Dose escalation and treatment monitoring are extremely important after PD and should be guided by a dietitian. There is no maximum dose in adults, but alternate or concurrent pathology (such as small intestinal bacterial overgrowth and bile acid malabsorption) should be considered where symptoms persist, despite doses exceeding 100,000 units per meal [103,104], or where dose escalation does not appear to result in a clinical benefit. An illustrated summary of interventions to improve nutritional status of PD patients is shown in Figure 2.…”

Section: Diagnosis and Management Of Postoperative Pancreatic Exocrin...mentioning

confidence: 99%

Recent Advances in Pancreatic Ductal Adenocarcinoma: Strategies to Optimise the Perioperative Nutritional Status in Pancreatoduodenectomy Patients

Halle‐Smith

Powell‐Brett

Hall

et al. 2023

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy for which the mainstay of treatment is surgical resection, followed by adjuvant chemotherapy. Patients with PDAC are disproportionately affected by malnutrition, which increases the rate of perioperative morbidity and mortality, as well as reducing the chance of completing adjuvant chemotherapy. This review presents the current evidence for pre-, intra-, and post-operative strategies to improve the nutritional status of PDAC patients. Such preoperative strategies include accurate assessment of nutritional status, diagnosis and appropriate treatment of pancreatic exocrine insufficiency, and prehabilitation. Postoperative interventions include accurate monitoring of nutritional intake and proactive use of supplementary feeding methods, as required. There is early evidence to suggest that perioperative supplementation with immunonutrition and probiotics may be beneficial, but further study and understanding of the underlying mechanism of action are required.

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Section: Diagnosis and Management Of Postoperative Pancreatic Exocrin...mentioning

confidence: 99%