title: Postoperative pancreatic exocrine function influences body weight maintenance after pylorus-preserving pancreatoduodenectomy.
abstract: BACKGROUND
  Most patients who undergo pylorus-preserving pancreatoduodenectomy (PPPD) are able to gain their weight postoperatively. However, sometimes patients experience a lack of weight gain even at long term after PPPD. The aim of this study was to examine factors influencing a body weight change after PPPD.
  
  
  METHODS
  In 34 Japanese patients with PPPD, 28 clinical parameters were assessed as possible factors affecting body weight maintenance at long term (1 year) after the operation by univariate and multivariate analyses.
  
  
  RESULTS
  Univariate analysis showed that long operation time (P = 0.02), extended retroperitoneal lymph node dissection (P = 0.0005), intraoperative radiotherapy (P = 0.02), adjuvant postoperative chemotherapy (P = 0.02), histopathological diagnosis of pancreatic cancer (P = 0.02), postoperative ulceration (P = 0.007), and insufficient postoperative pancreatic exocrine function (P = 0.002) were significantly related with the lack of weight gain at long term after PPPD. Multivariate analysis regarding the seven profound factors revealed that the insufficient postoperative pancreatic exocrine function significantly affected the lack of weight gain after PPPD. The use of ordinary amount of pancreatic exocrine enzymes did not influence the weight gain after PPPD (P = 0.23).
  
  
  CONCLUSIONS
  In patients refractory to an ordinary amount of medicine, a large dosage of enzymes may be necessary to gain weight after PPPD.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: K
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D002918:Chymotrypsin / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010179:Pancreas / Q000378:metabolism*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D010194:Pancreatin / Q000627:therapeutic use; D010195:Pancreatitis / Q000601:surgery; D015430:Weight Gain
chemical_list: D010194:Pancreatin; D002918:Chymotrypsin