Enzyme Substitution After Subtotal Cranial Pancreatic Resection Without Pancreaticoenterostomy
The nutritional and metabolic sequelae of complete pancreatic exocrine insufficiency in humans have proved difficult to assess for methodological reasons. However, few surgeons perform total pancreatectomy, mainly due to the bad long-term results and a considerable operative mortality and morbidity (Andrén-Sandberg and Ihse 1983; Gudjonssen 1987). When pancreatectomy is performed both endocrine insufficiency and maldigestion are unavoidable consequences (Kenneth et al. 1965; Miyata et al. 1980). These metabolic and nutritional complications probably account for a substantial proportion of both early and late morbidity — and in certain cases even mortality. However, since these conditions are concomitant, the relative importance of each is almost impossible to assess (Braasch et al. 1978; McConnell et al. 1980). Furthermore, our knowledge of the extent of maldigestion, malabsorption, and malnutrition in patients with pancreatic exocrine insufficiency is also scarce. Most published studies on pancreatic insufficiency are done in patients with chronic pancreatitis in whom some degree of pancreatic function still may be present (Lankisch et al. 1986, Malfertheiner et al. 1987). Besides, most of these patients have other sequelae of alcoholism, too.
KeywordsAlbumin Lactate Adenocarcinoma Lipase Pancreatitis
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