Malnutrition and diabetes outcomes 12 months after total pancreatectomy: A descriptive cohort study

BACKGROUND: Total pancreatectomy is a rare but increasingly performed surgical procedure that systematically induces endocrine and exocrine pancreatic insufficiency. Data on long-term nutritional outcomes after this surgery are limited. The objective of this study was to assess the prevalence of malnutrition at 3 months and 12 months after surgery and to evaluate diabetes control at 12 months. METHODS: We performed a descriptive cohort study in 41 adults who underwent total pancreatectomy at the Grenoble Alpes University Hospital (Grenoble, France) between January 2021 and July 2024. Nutritional status was defined according to national criteria based on weight loss, body mass index, and muscle mass with CT scan, or function. Data were collected before surgery, at 3 months, and at 12 months. RESULTS: A total of 41 patients were included. The prevalence of malnutrition increased from 25.0% (95% CI: 12.7-41.2) at the preoperative visit versus 59.5% (95% CI: 42.1-75.2) and 59.0% (95% CI: 42.1-74.4) at both 3 and 12 months. Weight loss exceeded 10% of usual body weight in more than half of patients at 12 months. At 12 months, all patients had type 3c diabetes with a median glycated hemoglobin at 8.0% (7.2-8.8, n = 32) and a time in hypoglycemia defined as the time below range of 0.2 (0.0-1.5). CONCLUSION: Malnutrition is highly prevalent after total pancreatectomy and persists at 12 months related to important weight loss, while diabetes appears manageable. These findings highlight the need for systematic nutritional monitoring and optimization of perioperative nutritional strategies in this population.