Postoperative management of patients with total exocrine pancreatic insufficiency

Br J Surg. 1990 Jun;77(6):669-72. doi: 10.1002/bjs.1800770626.

Abstract

The occurrence of maldigestion and malnutrition was studied in 14 patients who had undergone pancreaticoduodenectomy and occlusion of the Wirsung duct with Neoprene. Before discharge patients were put on a 70 g/day dietary fat intake. Mean faecal fat excretion was 32.9 g/day without enzyme replacement and fell to 14.2 g/day with pancrelipase supplementation. At discharge all patients were underweight (88 per cent of the usual mean body-weight) and nine patients showed alteration in laboratory nutritional parameters. At the time of discharge a low-fat diet (50 g/day) was prescribed. Six months after surgery, mean faecal fat excretion decreased further to 8.3 g/day (P less than 0.01) and all patients but one gained weight, reaching 93 per cent of the usual mean body-weight with normalized nutritional parameters. Our data show that the combination of enzyme replacement therapy and low-fat diet allows good correction of steatorrhoea and a significant improvement in nutritional status.

MeSH terms

  • Adult
  • Aged
  • Body Weight
  • Celiac Disease / therapy*
  • Dietary Fats / administration & dosage
  • Duodenum / surgery
  • Exocrine Pancreatic Insufficiency / diet therapy
  • Exocrine Pancreatic Insufficiency / drug therapy
  • Exocrine Pancreatic Insufficiency / therapy*
  • Female
  • Humans
  • Lipase / administration & dosage
  • Male
  • Middle Aged
  • Nutritional Status
  • Pancreas / surgery
  • Pancreatic Extracts / administration & dosage
  • Pancrelipase
  • Postoperative Care / methods

Substances

  • Dietary Fats
  • Pancreatic Extracts
  • Pancrelipase
  • Lipase