A clinical evaluation of reconstruction methods after pancreatoduodenectomy from a view of fat digestion and absorption

: The purpose of this study was to evaluate the reconstruction methods of modified Imanaga procedure and modified Child procedure from a point of fat digestion and absorption in patients who received pancreatoduodenectomy by using 13C-labelled medium chain fat. The 13CO2 abundances were elevated rapidly after oral ingestion of 13C-octanoic acid and 13C-trioctanoin in modified Imanaga procedure group. The peak 13CO2 abundances appeared earlier in modified Imanaga procedure group than in modified Child procedure group. No significant difference was seen between two groups in the percent recovery of 13CO2 in the breath after oral loading of 13C-octanoic acid. But modified Imanaga procedure group showed significantly higher recovery rate of 13CO2 of 13C-trioctanoin when compared to modified Child procedure group. These results suggest that modified Imanaga procedure would have a benefit for fat digestion and absorption after pancreatoduodenectomy.