Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Department of General and Pancreatic Surgery, Pancreas Institute, University and Hospital Trust of Verona, "GB Rossi" Hospital, Verona, Italy.
Dig Surg. 2022;39(4):169-175. doi: 10.1159/000526263. Epub 2022 Aug 2.
The impact of surgery on nutritional status, pancreatic function, and symptoms of patients affected by chronic pancreatitis (CP) has not been unequivocally determined. This study aimed to evaluate clinical follow-up after surgery for CP in an Italian-Austrian population.
Patients operated for CP at two high-volume centers between 2000 and 2018 were analyzed. The following parameters were compared between the pre- and postoperative period: nutritional status, endocrine and exocrine pancreatic functions, and chronic pain.
Overall, 186 patients underwent surgery for CP. Among these, 68 (40%) answered a specific follow-up questionnaire. The body mass index showed a significant increase between pre- and postoperative assessments (21.1 vs. 22.5 p = 0.003). Furthermore, a 60% decrease in the prevalence of chronic pain (81 vs. 21%, p < 0.001) was observed. On the contrary, both exocrine and endocrine pancreatic functions pointed toward a worsening after surgery, with consistent higher rates of patients presenting with diabetes mellitus, as well as patients requiring insulin therapy and oral intake of pancreatic enzymes. The analysis of body composition performed on 40 (24%) patients with a complete imaging pack revealed no significant change in the nutritional status after surgery.
DISCUSSION/CONCLUSION: Despite the good results observed in terms of pain relief, the surgical approach led to a consistent worsening of the global pancreatic function. No significant influence of surgery on the nutritional status of patients was detected.
手术对慢性胰腺炎(CP)患者的营养状况、胰腺功能和症状的影响尚未明确。本研究旨在评估意大利-奥地利两家高容量中心对 CP 患者进行手术后的临床随访情况。
分析了 2000 年至 2018 年间在两家高容量中心接受 CP 手术的患者。比较了术前和术后的以下参数:营养状况、内外分泌胰腺功能和慢性疼痛。
共有 186 例 CP 患者接受了手术。其中,68 例(40%)回答了特定的随访问卷。体重指数在术前和术后评估中显示出显著增加(21.1 对 22.5,p = 0.003)。此外,慢性疼痛的患病率下降了 60%(81 对 21%,p < 0.001)。相反,内外分泌胰腺功能均显示手术后恶化,糖尿病患者以及需要胰岛素治疗和口服胰酶的患者比例更高。对 40 名(24%)具有完整影像学包的患者进行的身体成分分析显示,手术后营养状况无明显变化。
讨论/结论:尽管在缓解疼痛方面取得了良好的效果,但手术方法导致整体胰腺功能持续恶化。手术对患者营养状况没有明显影响。