title: Effects of pancreatectomy on nutritional state, pancreatic function and quality of life.
abstract: BACKGROUND
  There are concerns about the extent of impaired endocrine and exocrine pancreatic function and poor quality of life (QoL) after pancreatectomy, but there is little information from large prospective follow-up studies.
  
  
  METHODS
  Consecutive patients undergoing pancreaticoduodenectomy or distal pancreatectomy between 2007 and 2011 were included. Relative bodyweight (RBW), triceps skinfold thickness (TSFT), serum protein, albumin, transferrin, fasting blood glucose, postprandial 2-h glucose (PP2), glycosylated haemoglobin A1c and stool elastase measurements, and European Organization for Research and Treatment of Cancer QLQ-C30 questionnaires were collected serially for 1 year.
  
  
  RESULTS
  Some 136 patients undergoing pancreatic resection completed the study. RBW and TSFT recovered to over 90 per cent of the preoperative value by 12 months, whereas transferrin, albumin and protein had returned to preoperative levels by 3 months. Diabetes mellitus, impaired fasting glucose or raised PP2 was present in 42 of 76 patients at 6 months and 36 of 76 at 12 months. Although steatorrhoea and diarrhoea had mainly resolved by 3 months, stool elastase level decreased after operation and showed no recovery. Nutritional status, pancreatic endocrine function and QoL returned to preoperative levels in 63 (46·3 per cent), 72 (52·9 per cent) and 77 (56·6 per cent) of 136 patients within 6 months of pancreatectomy. Multivariable analysis revealed that age 60 years or more, operation type, chronic pancreatitis and malignant disease had a significant impact on nutritional index, pancreatic function and QoL.
  
  
  CONCLUSIONS
  About half of all patients can expect recovery from pancreatectomy after 6 months, but those with risk factors need more careful follow-up and supportive management.
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Park
authors.forename: J-Y
authors.initials: JY
authors.lastname: Jang
authors.forename: E-J
authors.initials: EJ
authors.lastname: Kim
authors.forename: M J
authors.initials: MJ
authors.lastname: Kang
authors.forename: W
authors.initials: W
authors.lastname: Kwon
authors.forename: Y R
authors.initials: YR
authors.lastname: Chang
authors.forename: I W
authors.initials: IW
authors.lastname: Han
authors.forename: S-W
authors.initials: SW
authors.lastname: Kim
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight / Q000502:physiology; D005243:Feces / Q000737:chemistry; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007515:Islets of Langerhans / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D046790:Pancreas, Exocrine / Q000503:physiopathology* / Q000601:surgery; D010180:Pancreatectomy / Q000009:adverse effects*; D010182:Pancreatic Diseases / Q000503:physiopathology / Q000601:surgery*; D010196:Pancreatic Elastase / Q000378:metabolism; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D011446:Prospective Studies; D011788:Quality of Life; D012709:Serum Albumin / Q000378:metabolism; D012885:Skinfold Thickness; D014168:Transferrin / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D010196:Pancreatic Elastase; D012709:Serum Albumin; D014168:Transferrin