Muniz Cinara Knychala, Braga Camila Bitu Moreno, Kemp Rafael, Santos José Sebastião dos, Cunha Selma Freire de Carvalho da
Faculty of Medicine, Ribeirao Preto, SP, Brazil.
Acta Cir Bras. 2012 Feb;27(2):123-30. doi: 10.1590/s0102-86502012000200005.
To evaluate the nutritional status of patients in the late postoperative period of pancreaticoduodenectomy (PD) and compare the long-term outcome according to pylorus-preserving (PPPD) or the standard technique (SPD) in which the pylorus is resected.
This prospective study was conducted twelve months prior or more in patients who had underwent PD (PD Group, n=15) and health volunteers (Control Group, n=15). At a post hoc analysis, the PD Group was divided in PPPD Subgroup (n=9) and SPD Subgroup (n=6), according to the PD techniques. Gastrointestinal complaints and nutritional status were evaluated, apart from a biochemical assessment; Student t-test or Mann-Whitney test were used.
The patients recovered their body weight and the gastrointestinal complaints were uncommon. The PD Group showed higher energy and protein intake even though BMI was lower than in Control Group. There were no differences in laboratorial data, except for higher glycemia, serum alkaline phosfatase and C-reactive protein in PD Group. There was no difference in the various parameters evaluated when the Subgroups (PPPD and SPD) were compared.
For long-term pancreaticoduodenectomy, the gastrointestinal symptoms are minimal and the patients had the clinical and nutritional status preserved, regardless of pylorus preservation.
评估胰十二指肠切除术（PD）术后晚期患者的营养状况，并比较保留幽门的胰十二指肠切除术（PPPD）与切除幽门的标准术式（SPD）的长期预后。
这项前瞻性研究在接受PD手术的患者（PD组，n = 15）和健康志愿者（对照组，n = 15）中进行，时间为术前十二个月或更早。在事后分析中，根据PD技术将PD组分为PPPD亚组（n = 9）和SPD亚组（n = 6）。除生化评估外，还评估了胃肠道症状和营养状况；使用了学生t检验或曼-惠特尼检验。
患者恢复了体重，胃肠道症状并不常见。尽管PD组的体重指数低于对照组，但能量和蛋白质摄入量更高。实验室数据无差异，除了PD组的血糖、血清碱性磷酸酶和C反应蛋白较高。比较亚组（PPPD和SPD）时，评估的各项参数无差异。
对于长期胰十二指肠切除术，无论是否保留幽门，胃肠道症状均很轻微，患者的临床和营养状况得以维持。
