Abstract
Fourteen patients after pancreatoduodenectomy (PD) and 14 patients after gastrectomy were assessed nutritionally and immunologically. For the nutritional assessment, the percent of the ideal body weight was at the lowest limit in both groups of patients. On the other hand, the percent of triceps skinfold was moderately or severely reducted in the patients after PD with only slight or moderate reduction after gastrectomy. The red blood cell count and percent of lymphocytes in the white blood count were significantly lower in the patients after PD than in those receiving gastrectomy. The total cholesterol levels in the patients after PD were below normal. The levels of serum retinol-binding protein were markedly low, and were significantly less after PD than after gastrectomy. For the plasma free amino acids, the total amino acid levels tended to return normal, but Fischer's ratio tended to decrease, 5 years postoperatively in the patients who received PD. There was a tendency for the levels of serum complement to decrease and the levels of serum immunoglobulin to increase in the patients after PD. About 29% of the patients after PD and about 36% of the patients after gastrectomy had a negative response to tuberculin purified protein derivative. In conclusion, the patients after PD and gastrectomy had marasmus type malnutrition, which was more severe in the patients receiving PD.
