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Exocrine pancreatic insufficiency following bariatric surgery: unveiling alternative aetiology—case report and short review

European Journal of Clinical Nutrition volume 77, pages 1173–1175 (2023)Cite this article

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Abstract

Bariatric surgery (BS) is currently the most effective treatment for severe obesity, requiring ongoing multidisciplinary follow-up to ensure proper progress and nutrition post-procedure. Despite its favourable safety profile, it is not exempt from complications, one of which being exocrine pancreatic insufficiency (EPI). The underlying pathophysiological mechanisms of EPI after BS are multifactorial, including poorly synchronized pancreatic enzyme secretion with the passage of nutrients (pancreaticocibal or postcibal asynchrony), insufficient pancreatic stimulation and bacterial overgrowth. We conducted a short literature review of the topic through a case of a patient who underwent BS in our centre and subsequently developed EPI and severe malnutrition. EPI initially was attributed to the surgery, but after a comprehensive evaluation, an unexpected cause was revealed.

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Fig. 1: Abdominal Computed Tomography.

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Author information

Authors and Affiliations

  1. Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain

    Camila Milad, María Claro, Pere Leyes, Violeta Moizé, Amanda Jiménez & Ana de Hollanda

  2. Gastroenterology Department, Hospital Clínic, Barcelona, Spain

    Jorge Luis Nunez-Pizarro & Eva Vaquero

  3. Gastrointestinal Surgery Department, Barcelona, Spain

    Ainitze Ibarzábal

  4. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Eva Vaquero, Violeta Moizé, Amanda Jiménez & Ana de Hollanda

  5. Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

    Eva Vaquero & Xavier Molero

  6. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Asociadas. (CIBERDEM), Madrid, Spain

    Violeta Moizé

  7. Centro de Investigación Biomédica en Red de la Fisiopatología de la obesidad y Nutrición. (CIBEROBN), Madrid, Spain

    Amanda Jiménez & Ana de Hollanda

  8. Exocrine Pancreas Research Unit, Gastroenterology Department and Cistic Fibrosis Unit. Hospital Vall d´Hebron, Barcelona, Spain

    Xavier Molero

Authors
  1. Camila Milad
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  2. Jorge Luis Nunez-Pizarro
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  3. Ainitze Ibarzábal
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  4. María Claro
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  5. Pere Leyes
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  6. Eva Vaquero
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  7. Violeta Moizé
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  8. Amanda Jiménez
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  9. Xavier Molero
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  10. Ana de Hollanda
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Contributions

CM, ADH and JLN have written the paper; AI, MC, PL, EV, VM, AJ and XM have critically reviewed and contributed to the paper´s intellectual content. All authors have reviewed and approved the final version of the paper.

Corresponding author

Correspondence to Ana de Hollanda.

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The authors declare no competing interests.

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Milad, C., Nunez-Pizarro, J.L., Ibarzábal, A. et al. Exocrine pancreatic insufficiency following bariatric surgery: unveiling alternative aetiology—case report and short review. Eur J Clin Nutr 77, 1173–1175 (2023). https://doi.org/10.1038/s41430-023-01338-z

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  • DOI: https://doi.org/10.1038/s41430-023-01338-z

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