Nutritional status, fecal elastase-1, and 13C-labeled mixed triglyceride breath test in the long-term after pancreaticoduodenectomy

Pancreas. 2014 Apr;43(3):445-50. doi: 10.1097/MPA.0000000000000048.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ascorbic Acid / blood
  • Bacterial Load
  • Breath Tests / methods
  • Carbon Isotopes
  • Feces / enzymology
  • Female
  • Humans
  • Intestine, Small / microbiology
  • Male
  • Middle Aged
  • Nutritional Status*
  • Pancreatic Elastase / metabolism*
  • Pancreatic Function Tests
  • Pancreaticoduodenectomy*
  • Postoperative Period*
  • Retrospective Studies
  • Time Factors
  • Triglycerides / metabolism*
  • Vitamin A / blood
  • Young Adult
  • alpha-Tocopherol / blood

Substances

  • Carbon Isotopes
  • Triglycerides
  • Vitamin A
  • Pancreatic Elastase
  • alpha-Tocopherol
  • Ascorbic Acid