Our Summary

This research paper looks into a specific type of surgery called the Whipple procedure, or pancreatoduodenectomy, and its connection to anemia, which is a condition where the body lacks enough healthy red blood cells to carry oxygen to its tissues. The researchers hypothesize that patients who undergo this surgery develop iron deficiency anemia, a type of anemia caused by a lack of iron in the body.

The study looked at data from 74 patients who had the surgery between 2016 to 2018. They collected data before, during, and after the surgery, including the levels of hemoglobin (a protein in red blood cells that carries oxygen) and mean corpuscular volume (a measure of the average size of your red blood cells), as well as any treatments with radiation or chemotherapy, iron, and/or vitamin B12.

The results showed that all patients continued to have anemia after the surgery. The levels of hemoglobin decreased significantly at 1 and 6 months after the surgery, and the average size of red blood cells increased at 6 and 12 months. The anemia was not related to chemotherapy. Treatments with iron and vitamin B12, which were given to a small number of patients, did not improve the anemia.

The researchers conclude that future studies should look into why these treatments did not help, as adding nutrient supplements might be a necessary change in how these patients are cared for after surgery.

FAQs

  1. What is the hypothesized impact of the Whipple procedure on patients’ iron levels?
  2. How did the levels of hemoglobin and mean corpuscular volume change in patients post-pancreatoduodenectomy based on the study?
  3. Did the use of iron and vitamin B12 supplements help in reducing anemia in patients after a pancreatoduodenectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about the Whipple procedure is to ensure they are closely monitored for anemia post-surgery. It is important to discuss with your healthcare provider about potential iron and vitamin B12 supplementation to address any deficiencies and improve overall health and recovery. Regular follow-up appointments and blood tests can help track and manage any changes in hemoglobin levels.

Suitable For

Patients who are typically recommended for a Whipple procedure, also known as a pancreatoduodenectomy, include those with pancreatic cancer, ampullary cancer, bile duct cancer, and pancreatic neuroendocrine tumors. The procedure may also be recommended for patients with benign conditions such as chronic pancreatitis or benign tumors of the pancreas, bile ducts, or duodenum. The decision to undergo a Whipple procedure is typically made by a multidisciplinary team of healthcare providers based on the individual patient’s specific diagnosis and overall health status.

Timeline

Before Whipple procedure:

  • Patient undergoes preoperative evaluation, including blood tests to assess hemoglobin levels
  • Patient may undergo chemotherapy or radiation therapy as part of treatment plan
  • Patient is prepared for surgery, including fasting and bowel preparation

After Whipple procedure:

  • Patient is closely monitored in the hospital for complications and recovery
  • Patient may experience pain, nausea, and digestive issues in the immediate postoperative period
  • Patient may receive iron and vitamin B12 supplementation to address potential nutritional deficiencies
  • Patient undergoes follow-up appointments to monitor recovery and address any complications
  • Patient may continue to experience anemia and other post-surgical changes in the months following the procedure.

What to Ask Your Doctor

  1. How common is anemia after a Whipple procedure?
  2. What are the potential causes of anemia in patients post-pancreatoduodenectomy?
  3. How often should my hemoglobin levels be monitored after surgery?
  4. Are there specific dietary recommendations or supplements that can help prevent or treat anemia post-Whipple procedure?
  5. If I am experiencing symptoms of anemia, such as fatigue or weakness, what steps should I take?
  6. Are there any specific tests or evaluations that can help determine the underlying cause of my anemia?
  7. How does anemia after a Whipple procedure impact my overall recovery and long-term health?
  8. Are there any potential complications or risks associated with persistent anemia post-surgery?
  9. What treatment options are available for managing anemia in patients who have undergone a Whipple procedure?
  10. Should I seek the expertise of a nutritionist or dietitian to help address nutritional deficiencies that may contribute to anemia?

Reference

Authors: Jackson T, Vedantam S, Bradshaw R, Cho E, Lim J, Nagatomo K, Osman H, Jeyarajah DR. Journal: Expert Rev Gastroenterol Hepatol. 2020 Nov;14(11):1119-1123. doi: 10.1080/17474124.2020.1808459. Epub 2020 Aug 19. PMID: 32772584