{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:47:57Z","timestamp":1791910077689,"version":"4.3.4"},"reference-count":12,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Surg"],"abstract":"<jats:p>Introduction: Exocrine pancreatic insufficiency (EPI) and malnutrition are prevalent but systematically underestimated in patients with periampullary tumors. Methods: This is a prospective observational single-center study. Thirty-two patients with potentially resectable periampullary tumors underwent nutritional assessment including fecal elastase-1 (FE-1), psoas muscle index (PMI) on CT, bioelectrical impedance analysis with phase angle, and handgrip strength. Postoperative complications, Textbook Outcome (TO), and nutritional follow-up at 1, 3, and 6 months were assessed in 23 resected patients. Results: This study found EPI (FE-1 &lt;200 \u03bcg\/g) was present in 76.9% (20\/26) of patients. Prealbumin was &lt;20 mg\/dL in 62.1% and vitamin D deficient in 82.8%, despite normal albumin in most patients. Sarcopenia by PMI was detected in 53.1% (17\/32) of the full preoperative cohort, substantially higher than handgrip strength alone (15\u201317%). After resection, universal EPI (100%) was confirmed. TO was achieved in 73.9% (17\/23) of patients. Median weight declined from 64.0 kg preoperatively to 61.2 kg at 6 months; cumulative weight loss from pre-illness habitual weight reached 18.5% at 6 months, of which 9.2% had already occurred before surgery. Vitamin D deficit persisted throughout follow-up; sarcopenia was numerically higher at 1 month (68.8%), with values returning toward baseline by 6 months (65.2%). Conclusion: Patients with periampullary tumors present a severe, multidimensional preoperative nutritional burden more prevalent than recognized. Systematic assessment should be incorporated into standard protocols within a structured multidisciplinary perioperative pathway.<\/jats:p>","DOI":"10.1159\/dsu\/acoag004","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:33:58Z","timestamp":1788521638000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Exocrine Pancreatic Insufficiency and Nutritional Status in Patients with Resectable and Borderline Resectable Periampullary Tumors: A Prospective Longitudinal Study"],"prefix":"10.1159","author":[{"given":"Eric","family":"Herrero Fonollosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sobrerroca Porras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montse","family":"Ibarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Jos\u00e9","family":"Barahona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Camps-Lasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Galofr\u00e9-Recasens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Rodr\u00edguez Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvadora","family":"Delgado Rivilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Cugat Andorr\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabel","family":"Garc\u00eda Domingo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/s0149-2918(05)80001-3"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12674"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-25-0237"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003451"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70153-0"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz046"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2007.10.007"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.07.010"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318296c732"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2025.106573"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2025.08.029"}],"container-title":["Digestive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/dsu\/acoag004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:01:33Z","timestamp":1791907293000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/dsu\/acoag004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":12,"URL":"https:\/\/doi.org\/10.1159\/dsu\/acoag004","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33394006","asserted-by":"subject"}]},"ISSN":["0253-4886","1421-9883"],"issn-type":[{"value":"0253-4886","type":"print"},{"value":"1421-9883","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}