The role of pancreatic enzyme replacement therapy (PERT) in malignant pancreatic disease, when should we start it?

Pancreatic cancer is the 4th leading cause of cancer death worldwide. It has 9% 5-year survival and has a devastating effect on patient’s quality of life. A major contributing factor to the effects of pancreatic cancer is malnutrition. About 30% of patients are malnourished; 80% of patients suffer from a significant loss of weight and over one third have lost >10% of their body weight at the time of diagnosis. As the disease progresses it leads to cachexia. This renders patients more vulnerable to many complications along their pancreatic cancer journey.

Surgery for chronic pancreatitis

Chronic pancreatitis (CP) is a progressive fibroinflammatory process of the pancreas in which pancreatic secretory functional parenchyma is damaged and subsequently replaced by fibrous tissue. This often results in morphological changes in the pancreatic ducts and parenchyma. The culmination of these changes is the permanent impairment of the pancreas’ exocrine and endocrine function. Diagnosis of CP is based on recognition of this impaired function as well as the recognition of the morphological changes on imaging including endoscopic ultrasound evaluation.


Health Professions Council of South Africa


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Pancreas Matters - Vol 6 No 1 - 2023