Transient Exocrine Pancreatic Insufficiency: First Report of an Unrecognized Complication of Cytoreductive Surgery and HIPEC

Naffouje, Samer A.; Salti, George I.

doi:10.21873/anticanres.12482

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…One surgical procedure for which EPI has recently been documented is cytoreductive surgery 42 . The authors noted that refractory diarrhea is a significant problem following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, being seen in 42.3% of patients.…”

Section: Nonpancreatic Surgery and Fat Malabsorptionmentioning

confidence: 99%

Exocrine pancreatic insufficiency and fat malabsorption related to pancreatectomy and other gastrointestinal surgery: A narrative review

Morris‐Stiff

2024

Nut in Clin Prac

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Surgical resection is the mainstay of treatment for patients with tumors of the pancreas. There are a number of well‐recognized complications that account for the significant morbidity associated with the operation, including exocrine pancreatic insufficiency (EPI). Patients with pancreatic cancer commonly have evidence of EPI prior to surgery, and this is exacerbated by an operation, the extent of the insult being dependent on the indication for surgery and the operation performed. There are accumulating data to demonstrate that treatment of EPI with pancreatic enzyme replacement (PERT) enhances clinical outcomes after surgery by reducing critical complications; this in turn may enhance oncological outcomes. Data would indicate that quality of life (QoL) is also improved after surgery when enzymes are prescribed. To date, many surgeons and clinicians have not appreciated the need for PERT or the benefits it may bring to their patients; therefore, education of clinicians remains a significant opportunity. In turn, patient education about consumption of the correct dose of enzymes at the appropriate time is key to an optimal outcome. In addition, because of the complex nature of the regulation of pancreatic exocrine function, there is evidence to support the presence of EPI following operations performed on other gastrointestinal (GI) organs, including the esophagus, stomach, and small intestine. The aim of this review is to document the existing published evidence in relation to EPI and its treatment with PERT following GI surgery.

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Section: Nonpancreatic Surgery and Fat Malabsorptionmentioning

confidence: 99%