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Pancreaticoduodenectomy for peri-ampullary neoplasia leads to specific micronutrient deficiencies

Pancreaticoduodenectomy for peri-ampullary neoplasia leads to specific micronutrient deficiencies
Pancreaticoduodenectomy for peri-ampullary neoplasia leads to specific micronutrient deficiencies
Background/Aims: After pancreaticoduodenectomy ( PD) patients may be deficient in essential micronutrients. This study was designed to determine if this is a consequence of surgery.
Methods: Long-term survivors (> 6 months) of PD for peri-ampullary neoplasia and healthy controls ( patients' spouse/partner) were enrolled in the study. Specific clinical parameters were recorded, serum micronutrient levels were measured and subjects completed 7-day food diaries.
Results: Thirty-seven patients were studied, 25 with paired controls. All were well nourished, as defined by body mass index and food diary analysis. Patients with paired controls were representative of all patients studied. Patients had raised transferrin ( median 2.60 vs. 2.16 g/l, p = 0.001) and low ferritin levels (34.9 vs. 119.0 g/ l, p < 0.001) indicating relative iron deficiency. Patients also demonstrated lower levels of the anti-oxidants selenium (0.77 vs. 0.93 mu mol/l, p < 0.001) and vitamin E (23.2 vs. 35.7 mu mol/ l, p < 0.001) with 57% of patients having frank selenium deficiencies. Patients had lower levels of vitamin D than controls (15.7 vs. 19.6 mu mol/l, p = 0.001) and 30% of patients had a raised parathyroid hormone level, suggesting compensatory mechanisms operate to maintain normocalcaemia.
Conclusions: Long-term survivors of PD are relatively deficient in several micronutrients compared to non-operated controls taking the same diet. We recommend that micronutrient status should be regularly checked in these patients and treated where necessary.
pancreatitis, time, surgery, iron-deficiency, pancreaticoduodenectomy, selenium, mechanism, trace-element, deficient, iron, patient, whipple's procedure, quality-of-life, diet, micronutrients, bone metabolism, nutrition
1424-3903
37-44
Armstrong, T.
fe074aba-a53c-4db6-b007-af761cd75235
Strommer, L.
4d06bc54-fdb1-4fc4-963b-0a92e17c9243
Ruiz-Jasbon, F.
9faa5052-faa8-45dd-ba48-a87caf1886c3
Shek, F.W.
d92c04e4-ff88-403f-af45-9328f57ad8c2
Harris, S.F.
19ea097b-df15-4f0f-be19-8ac42c190028
Permert, J.
15b60553-b43a-4e6a-9cf3-4d94b4db07a6
Johnson, C.D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a
Armstrong, T.
fe074aba-a53c-4db6-b007-af761cd75235
Strommer, L.
4d06bc54-fdb1-4fc4-963b-0a92e17c9243
Ruiz-Jasbon, F.
9faa5052-faa8-45dd-ba48-a87caf1886c3
Shek, F.W.
d92c04e4-ff88-403f-af45-9328f57ad8c2
Harris, S.F.
19ea097b-df15-4f0f-be19-8ac42c190028
Permert, J.
15b60553-b43a-4e6a-9cf3-4d94b4db07a6
Johnson, C.D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a

Armstrong, T., Strommer, L., Ruiz-Jasbon, F., Shek, F.W., Harris, S.F., Permert, J. and Johnson, C.D. (2007) Pancreaticoduodenectomy for peri-ampullary neoplasia leads to specific micronutrient deficiencies. Pancreatology, 7 (1), 37-44. (doi:10.1159/000101876).

Record type: Article

Abstract

Background/Aims: After pancreaticoduodenectomy ( PD) patients may be deficient in essential micronutrients. This study was designed to determine if this is a consequence of surgery.
Methods: Long-term survivors (> 6 months) of PD for peri-ampullary neoplasia and healthy controls ( patients' spouse/partner) were enrolled in the study. Specific clinical parameters were recorded, serum micronutrient levels were measured and subjects completed 7-day food diaries.
Results: Thirty-seven patients were studied, 25 with paired controls. All were well nourished, as defined by body mass index and food diary analysis. Patients with paired controls were representative of all patients studied. Patients had raised transferrin ( median 2.60 vs. 2.16 g/l, p = 0.001) and low ferritin levels (34.9 vs. 119.0 g/ l, p < 0.001) indicating relative iron deficiency. Patients also demonstrated lower levels of the anti-oxidants selenium (0.77 vs. 0.93 mu mol/l, p < 0.001) and vitamin E (23.2 vs. 35.7 mu mol/ l, p < 0.001) with 57% of patients having frank selenium deficiencies. Patients had lower levels of vitamin D than controls (15.7 vs. 19.6 mu mol/l, p = 0.001) and 30% of patients had a raised parathyroid hormone level, suggesting compensatory mechanisms operate to maintain normocalcaemia.
Conclusions: Long-term survivors of PD are relatively deficient in several micronutrients compared to non-operated controls taking the same diet. We recommend that micronutrient status should be regularly checked in these patients and treated where necessary.

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More information

Published date: 2007
Keywords: pancreatitis, time, surgery, iron-deficiency, pancreaticoduodenectomy, selenium, mechanism, trace-element, deficient, iron, patient, whipple's procedure, quality-of-life, diet, micronutrients, bone metabolism, nutrition

Identifiers

Local EPrints ID: 62677
URI: https://eprints.soton.ac.uk/id/eprint/62677
ISSN: 1424-3903
PURE UUID: fc99ab00-75ba-4ad9-8dcc-0115bb38667a

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Date deposited: 09 Sep 2008
Last modified: 13 Mar 2019 20:27

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