Pancreaticoduodenectomy with pancreaticogastrostomy: assessment of patients' nutritional status, quality of life and pancreatic exocrine function.

Abstract

Background: The changes in digestive function of patients with pancreaticoduodenectomy (PD) and pancreaticogastrostomy reconstruction have not been well-documented. The present study sought to assess the nutritional status, quality of life and pancreatic exocrine function in this group of patients.

Methods: The study group consisted of 11 PD with pancreaticogastrostomy patients. The control group consisted of 11 consecutive patients who had subtotal gastrectomy (SG) for distal stomach tumours.

Results: The median ages for the PD and SG groups were 57 and 59 years, respectively. The median intervals between surgery to assessment were 68 and 60 weeks, respectively. The PD group attained a mean of 92.7% of their pre-surgery weight compared to 91.3% in the SG group. Both groups had a comparable gastrointestinal quality of life index and Visick scale scores. Exocrine insufficiency using the faecal chymotrypsin test was present in 36% of patients with PD. None of the patients in the SG group had exocrine insufficiency.

Conclusion: Pancreaticoduodenectomy patients had a significant occurrence of pancreatic exocrine insufficiency compared to the SG group. But patients with PD and pancreaticogastrostomy reconstruction maintained a nutritional status and quality of life similar to those with curative SG for stomach malignancy. Apart from exocrine insufficiency, the concomitant gastrectomy in the PD group is an important factor responsible for their inability to gain weight.