Pancreatic exocrine insufficiency following pancreatic resection.

Major pancreatic resection can cause pancreatic enzyme insufficiency with fat malabsorption, resulting in symptoms of abdominal pain, steatorrhoea and weight loss which can be extremely debilitating. The most important factors influencing subsequent development of steatorrhoea are the extent and type of surgical resection and the underlying disease process. The resultant steatorrhoea can be marked and difficult to control. There have been relatively few randomised controlled studies which have addressed this particular problem in patients who have had pancreatectomy. The use of effective doses of pancreatic enzyme supplements is essential in those patients who are symptomatic. When stabilised on therapeutically effective doses of pancreatic enzyme supplements, however, over 30% of patients still have evidence of significant levels of steatorrhoea. These results emphasise that the complete eradication of steatorrhoea is still not feasible at the present time, even using the best currently available agents, highlighting the need for further effective therapies.