Long-term changes in body composition after pancreatoduodenectomy.
Body protein and fat stores were measured in four long-term survivors both before Whipple's procedure for malignancy at the ampulla of Vater and at a mean of 40 months (range 20-64 months) later. The results were compared with predicted well values. At follow-up patients also underwent dietary assessment and measurement of faecal fat losses. A dietary intake of mean (s.d) of 2690 (733) kcal per day and 85 (21) g protein per day met the patients' requirements. There was notable steatorrhoea (faecal fat 28 (21) g per day) but faecal protein losses were normal. Before surgery, body-weight was significantly lower than well-weight (P less than 0.0005), three patients having body fat stores lower than predicted well values. After surgery, body-weight and protein stores did not change significantly but fat stores fell in each patient (P less than 0.04). A curative Whipple's procedure prevents further weight loss in ampullary malignancy but weight gain does not occur because of steatorrhoea, perhaps a result of the accompanying truncal vagotomy.
Curran
F T
FT
University Department of Surgery, Auckland Hospital, New Zealand.
Stokes
M A
MA
Hill
G L
GL
D007516:Adenoma, Islet Cell / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D001823:Body Composition; D002277:Carcinoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002768:Choledochostomy; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004044:Dietary Proteins / Q000627:therapeutic use; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010193:Pancreaticojejunostomy; D013997:Time Factors; D015167:Vagotomy, Truncal; D015431:Weight Loss / Q000502:physiology
D004044:Dietary Proteins