Fat malabsorption and reduced exocrine pancreatic function after gastroesophageal cancer surgery

BACKGROUND: Patients post-gastroesophageal cancer surgery frequently present with clinical features of malabsorption and are often treated empirically with pancreatic enzyme replacement therapy (PERT). Primary aim was to objectify the presence of fat malabsorption in patients after gastroesophageal surgery and, secondary, to measure exocrine pancreatic function. METHODS: Eligible patients were those who underwent gastroesophageal cancer surgery (2017-2021), were at least six months post-surgery, maintained an oral diet, and showed no evidence of recurrent disease. Treatment with PERT was ceased prior to this study. Fecal fat balance test (coefficient of fat absorption, CFA (%)) was used to measure absorption of fat. The CFA was determined by collecting feces over three days to measure daily fecal fat excretion (g/d), along with a four-day (weighted) nutritional diary, to establish the average daily fat intake (g/d). Fat malabsorption was defined as a CFA