Abstract
In diseases of the biliary tract, secretion of bile and pancreatic juice is affected by the diseases themselves and surgical treatment. In addition, endocrinopathy of the pancreas develops. For digestion and absorption disorders due to the disorder of bile and pancreatic juice secretion, meal instruction and medication, including enzyme supplement therapy, are conducted. Abdominal symptoms due to indigestion disorder should be dealt with by increasing drug use, and the permanent limitation of food is a last resort. In highly invasive surgeries such as pancreaticoduodenectomy, preoperative immunonutrition should be considered. In addition, early supplemental enteral nutrition via a nasojejunal tube, of which the tip is placed on the anal side of enteral anastomoses, should be considered. In patients who have undergone surgery including gastrectomy, attention should be paid to iron deficiency anemia and deficiency of vitamin B12. The oral administration of vitamin B12 is effective even in those who have undergone gastrectomy. Sufficient enzyme replacement therapy should be performed to avoid the need for food restriction even after PD. Careful observation should be performed to check for weight loss, and early and appropriate treatment is mandatory if a patient shows significant weight loss.
