Long-term EPI management after pancreatic surgery needs specialist guidance

Key clinical point: Considerable proportion of patients suffer from exocrine pancreatic insufficiency (EPI)-associated complaints which persisted for 3 years or even more after pancreatoduodenectomy or left pancreatectomy, even in patients receiving pancreatic enzyme replacement therapy (PERT).

Major finding: EPI, indicated by PERT usage, was reported in 41% of patients, of which only 48% reported complete relief, whereas 35% reported decrease in EPI-related complaints. Patients with vs. without PERT had higher complaints of fatty stools (50% vs. 26%; P = .003) and unintentional weight loss (11% vs. 2%; P = .019).

Study details: This study included 153 patients who underwent pancreatoduodenectomy or left pancreatectomy for premalignant or benign diseases between 2006 and 2016.

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Disclosures: This study was supported by the Dutch Cancer Society. The lead author reported research funding from Mylan and Allergan.

Source: Latenstein AEJ et al. HPB. 2021 Apr 27. doi: 10.1016/j.hpb.2021.04.012.