Department of Nutrition and Dietetics, Royal Surrey Hospital, Guildford GU2 7XX, UK.
Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7NX, UK.
Nutrients. 2023 Jun 19;15(12):2804. doi: 10.3390/nu15122804.
Pancreatico-duodenectomy (PD) includes resection of the duodenum and use of the proximal jejunum in a blind loop, thus reducing the absorptive capacity for vitamins and minerals. Several studies have analysed the frequency of micronutrient deficiencies, but there is a paucity of data on those taking routine supplements. A retrospective review of medical notes was undertaken on 548 patients under long-term follow-up following PD in a tertiary hepato-pancreatico-biliary centre. Data were available on 205 patients from 1-14 years following PD, and deficiencies were identified as follows: vitamin A (3%), vitamin D (46%), vitamin E (2%), iron (42%), iron-deficiency anaemia (21%), selenium (3%), magnesium (6%), copper (1%), and zinc (44%). Elevated parathyroid hormone was present in 11% of cases. There was no significant difference over time ( > 0.05). Routine supplementation with a vitamin and mineral supplement did appear to reduce the incidence of biochemical deficiency in vitamin A, vitamin E, and selenium compared to published data. However, iron, vitamin D, and zinc deficiencies were prevalent despite supplementation and require surveillance.
胰十二指肠切除术（PD）包括十二指肠切除术和使用近端空肠盲袢，从而降低了维生素和矿物质的吸收能力。有几项研究分析了微量营养素缺乏的频率，但关于常规补充剂的资料很少。对一家三级肝胆胰中心进行 PD 治疗后长期随访的 548 名患者的病历进行了回顾性分析。PD 后 1 至 14 年的数据可用于 205 名患者，确定存在以下缺乏症：维生素 A（3%）、维生素 D（46%）、维生素 E（2%）、铁（42%）、缺铁性贫血（21%）、硒（3%）、镁（6%）、铜（1%）和锌（44%）。甲状旁腺激素升高的病例占 11%。随着时间的推移（>0.05）没有显著差异。与已发表的数据相比，常规补充维生素和矿物质补充剂似乎确实可以降低维生素 A、维生素 E 和硒的生化缺乏发生率。然而，尽管进行了补充，但铁、维生素 D 和锌缺乏仍然很普遍，需要进行监测。
