Pancreatic exocrine insufficiency after pancreaticoduodenectomy: Current evidence and management  

作　　者：Adithya M Pathanki Joseph A Attard Elizabeth Bradley Sarah Powell-Brett Bobby V M Dasari John R Isaac Keith J Roberts Nikolaos A Chatzizacharias 

机构地区：[1]Department of HPB and Liver Transplantation,Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham B152TH,United Kingdom [2]Department of Nutrition and Dietetics,Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham B152TH,United Kingdom

出　　处：《World Journal of Gastrointestinal Pathophysiology》2020年第2期20-31,共12页世界胃肠病理生理学杂志（英文版）（电子版）

摘　　要：Pancreaticoduodenectomy(PD)is the commonest procedure performed for pancreatic cancer.Pancreatic exocrine insufficiency(PEI)may be caused or exacerbated by surgery and remains underdiagnosed and undertreated.The aim of this review was to ascertain the incidence of PEI,its consequences and management in the setting of PD for indications other than chronic pancreatitis.A literature search of databases(MEDLINE,EMBASE,Cochrane and Scopus)was carried out with the MeSH terms“pancreatic exocrine insufficiency”and“Pancreaticoduodenectomy”.Studies that analysed PEI and its complications in the setting of PD for malignant and benign disease were included.Studies reporting PEI in the setting of PD for chronic pancreatitis,conference abstracts and reviews were excluded.The incidence of PEI approached 100%following PD in some series.The pre-operative incidence varied depending on the characteristics of the patient cohort and it was higher(46%-93%)in series where pancreatic cancer was the predominant indication for surgery.Variability was also recorded with regards to the method used for the diagnosis and evaluation of pancreatic function and malabsorption.Pancreatic enzyme replacement therapy is the mainstay of the management.PEI is common and remains undertreated after PD.Future studies are required for the identification of a welltolerated,reliable and reproducible diagnostic test in this setting.

关 键 词：PANCREATIC EXOCRINE INSUFFICIENCY PANCREATICODUODENECTOMY PANCREATIC ENZYME replacement therapy PANCREATIC cancer MALABSORPTION Steatorrhoea 

分 类 号：R735.9[医药卫生—肿瘤]