title: Long-term nutritional and metabolic consequences of pancreaticoduodenectomy in children.
abstract: BACKGROUND
  The long-term nutritional and metabolic consequences of pancreaticoduodenectomy in children are unknown.
  
  
  METHODS
  Five children were evaluated in a clinical research center 2.5 to 10 years after pancreaticoduodenectomy to assess their nutritional status based on patterns of growth and to assess their gastrointestinal function. Investigation included vitamin levels, a bentiromide study, and serum immunoreactive trypsinogen levels to evaluate pancreatic function and a d-xylose absorption and a radionuclide gastric emptying scan for intestinal absorption and motility.
  
  
  RESULTS
  Children were able to grow after pancreaticoduodenectomy. Three remained in low percentile groups for height/weight ratio, and two were near or above normal. Low normal levels of the fat-soluble vitamins were present. Very low levels of pancreatic function were found based on the bentiromide and trypsinogen studies, whereas intestinal absorption of d-xylose was normal except for one patient with extremely rapid gastric emptying.
  
  
  CONCLUSIONS
  After pancreaticoduodenectomy children can grow and develop normally if given adequate levels of oral pancreatic supplements to replace the severely decreased level of endogenous pancreatic enzymes after operation. Routine supplementation of the fat-soluble vitamins should be considered.
authors.affiliation: Department of Surgery, Children's Hospital, Boston, Mass. 02115.
authors.forename: R C
authors.initials: RC
authors.lastname: Shamberger
authors.forename: W H
authors.initials: WH
authors.lastname: Hendren
authors.forename: A M
authors.initials: AM
authors.lastname: Leichtner
mesh_terms: D010129:4-Aminobenzoic Acid; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005746:Gastric Emptying; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D006887:Hydroxycholecalciferols / Q000172:deficiency; D007408:Intestinal Absorption; D009748:Nutrition Disorders / Q000188:drug therapy / Q000209:etiology*; D010179:Pancreas / Q000503:physiopathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010194:Pancreatin / Q000172:deficiency / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000209:etiology; D014808:Vitamin D Deficiency / Q000209:etiology; D014994:Xylose; D062366:para-Aminobenzoates
chemical_list: D006887:Hydroxycholecalciferols; D062366:para-Aminobenzoates; C006717:bentiromide; D010194:Pancreatin; D014994:Xylose; D010129:4-Aminobenzoic Acid