title: Postoperative management of patients with total exocrine pancreatic insufficiency.
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.
authors.affiliation: Scientific Institute, San Raffaele Hospital, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Braga
authors.forename: A
authors.initials: A
authors.lastname: Zerbi
authors.forename: S
authors.initials: S
authors.lastname: Dal Cin
authors.forename: R
authors.initials: R
authors.lastname: De Franchis
authors.forename: A
authors.initials: A
authors.lastname: Malesci
authors.forename: V
authors.initials: V
authors.lastname: Di Carlo
mesh_terms: D000328:Adult; D000368:Aged; D001835:Body Weight; D002446:Celiac Disease / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D004386:Duodenum / Q000601:surgery; D010188:Exocrine Pancreatic Insufficiency / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008049:Lipase / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010179:Pancreas / Q000601:surgery; D010184:Pancreatic Extracts / Q000008:administration & dosage; D020799:Pancrelipase; D011182:Postoperative Care / Q000379:methods
chemical_list: D004041:Dietary Fats; D010184:Pancreatic Extracts; D020799:Pancrelipase; D008049:Lipase