title: Nutritional status, fecal elastase-1, and 13C-labeled mixed triglyceride breath test in the long-term after pancreaticoduodenectomy.
abstract: OBJECTIVE
  This study aimed to compare the body composition, dietary intake and serum levels of vitamins and minerals, and exocrine pancreatic function in patients late after pancreaticoduodenectomy (PD) and healthy subjects.
  
  
  METHODS
  Fifteen patients (PD group) who had undergone PD over 1 year before the study and 15 health volunteers (control group) were included in the study. All volunteers underwent dietary intake evaluation, body composition, laboratory data, exocrine pancreatic function by elastase-1, and carbon (C )-labeled triglycerides in breath tests. The PD group subjects also underwent upper gastrointestinal endoscopy and small intestinal bacterial overgrowth analysis.
  
  
  RESULTS
  Nutrient intake was adequate, and there were no differences in body mass index and mineral serum levels between the groups. The PD group showed lower serum levels of retinol, α-tocopherol, and ascorbic acid. Small intestinal bacterial overgrowth occurred in 39% of the patients. Fecal elastase-1 was lower in the PD group. The PD group had a higher C peak time; the cumulative label C recovery in 7 hours was similar in both groups.
  
  
  CONCLUSIONS
  Fecal elastase-1 decreased, and the excretion of C in breath was similar to healthy controls. Although the data point toward an adaptation in the absorptive capacity of fats, A, C, and E hypovitaminosis indicate that some absorptive insufficiency persists late after PD.
authors.affiliation: From the *Medical Nutrition Discipline, Department of Internal Medicine, †Biliary Tract and Pancreas Group, Department of Surgery, and ‡Division of General Internal and Geriatrics Medicine, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Cinara Knychala
authors.initials: CK
authors.lastname: Muniz
authors.forename: José Sebastião
authors.initials: JS
authors.lastname: dos Santos
authors.forename: Karina
authors.initials: K
authors.lastname: Pfrimer
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ferrioli
authors.forename: Rafael
authors.initials: R
authors.lastname: Kemp
authors.forename: Júlio Sérgio
authors.initials: JS
authors.lastname: Marchini
authors.forename: Selma Freire
authors.initials: SF
authors.lastname: Cunha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000097:blood; D058491:Bacterial Load; D001944:Breath Tests / Q000379:methods; D002247:Carbon Isotopes; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010196:Pancreatic Elastase / Q000378:metabolism*; D010186:Pancreatic Function Tests; D016577:Pancreaticoduodenectomy; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000378:metabolism*; D014801:Vitamin A / Q000097:blood; D055815:Young Adult; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D002247:Carbon Isotopes; D014280:Triglycerides; D014801:Vitamin A; D010196:Pancreatic Elastase; D024502:alpha-Tocopherol; D001205:Ascorbic Acid