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

Background: The changes in digestive function of patients with pancreaticod uodenectomy (PD) and pancreaticogastrostomy reconstruction have not been we ll-documented. The present study sought to assess the nutritional status, q uality of life and pancreatic exocrine function in this group of patients. Methods: The study group consisted of 11 PD with pancreaticogastrostomy pat ients. The control group consisted of 11 consecutive patients who had subto tal gastrectomy (SG) for distal stomach tumours. Results: The median ages for the PD and SG groups were 57 and 59 years, res pectively. The median intervals between surgery to assessment were 68 and 6 0 weeks, respectively. The PD group attained a mean of 92.7% of their pre-s urgery weight compared to 91.3% in the SG group. Both groups had a comparab le gastrointestinal quality of life index and Visick scale scores. Exocrine insufficiency using the faecal chymotrypsin test was present in 36% of pat ients with PD. None of the patients in the SG group had exocrine insufficie ncy. Conclusion: Pancreaticoduodenectomy patients had a significant occurrence o f 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 ma lignancy. Apart from exocrine insufficiency, the concomitant gastrectomy in the PD group is an important factor responsible for their inability to gai n weight.