131: THE EFFECT OF PANCREATIC ENZYME REPLACEMENT THERAPY ON COMPLAINTS OF MALABSORPTION AFTER ESOPHAGECTOMY FOR CANCER

Abstract Background and aim Pancreatic enzymes are often prescribed in clinical practice to treat complaints of maldigestion and malabsorption after esophagectomy for cancer, but knowledge regarding the effect of this treatment on malabsorption related complaints is lacking. Aim of this study is to evaluate the presence of malabsorption related complaints after esophagectomy and to determine whether treatment with pancreatic enzymes is effective. Methods This single-center, retrospective cohort study included patients after esophagectomy for cancer between 2014 and 2019 at Amsterdam UMC location VU medical center. Medical charts of patients with a postoperative follow-up period of at least 6 months were screened. Endpoints of this study were (1) patient reported signs of malabsorption, defined as; steatorrhea or diarrhea alone, or in combination with weight loss, abdominal pain, flatulence or abdominal bloating, and (2) the effect of treatment with pancreatic enzymes on these complaints. Results This cohort included 184 patients. Median postoperative follow-up was 24 months (range 6–78 months). Complaints of postoperative malabsorption were present in 38.6%. Of all patients suffering from malabsorption related complaints, 59.2% received an empirical trial with pancreatic enzymes. The majority of patients (85.7%) reported a positive effect of treatment with pancreatic enzymes, varying from a complete resolution, to a mild reduction of symptoms. Median period between surgery and starting pancreatic enzymes was 7 months (range 0–53 months). Conclusion Based on these data, pancreatic enzymes seem to be effective in the treatment of malabsorption related complaints after esophagectomy for cancer and should therefore be considered in postoperative patients reporting malabsorption related complaints.