Pancreatic enzyme replacement therapy after gastric resection: An update

Dig Liver Dis. 2018 Jan;50(1):1-5. doi: 10.1016/j.dld.2017.10.025. Epub 2017 Nov 10.


Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery, together with reduced food intake, loss of gastric reservoir, small bowel bacterial overgrowth and rapid small bowel transit. Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI. The efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear. This review article summarizes relevant studies addressing PERT after gastric resection.

Keywords: Exocrine pancreatic insufficiency; Gastrectomy; Pancreatic enzyme; Surgery.

Publication types

  • Review

MeSH terms

  • Enzyme Replacement Therapy / methods*
  • Exocrine Pancreatic Insufficiency / drug therapy*
  • Exocrine Pancreatic Insufficiency / etiology
  • Exocrine Pancreatic Insufficiency / physiopathology
  • Gastrectomy / adverse effects*
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Pancreas / drug effects*
  • Pancreas / enzymology
  • Randomized Controlled Trials as Topic


  • Gastrointestinal Agents