Metabolic Sequelae of Pancreatic Disease and Pancreatic Surgery: Exocrine–Endocrine Failure, Nutrition, and Precision Treatment

Pancreatic diseases and pancreatic surgery are frequently followed by complex and underrecognized metabolic consequences that can profoundly affect quality of life, long-term outcomes, and healthcare utilization. Chronic pancreatitis, pancreatic cancer, cystic lesions, acute pancreatitis, and pancreatic resections may all disrupt the delicate exocrine–endocrine balance of the pancreas, leading to pancreatic exocrine insufficiency, pancreatogenic diabetes, malnutrition, sarcopenia, micronutrient deficiencies, and impaired functional recovery. Despite growing awareness of these complications, metabolic sequelae remain inconsistently diagnosed and undertreated in routine clinical practice.The clinical burden of exocrine–endocrine failure is especially relevant in the era of multidisciplinary pancreatic care. Patients undergoing pancreatoduodenectomy, distal pancreatectomy, or total pancreatectomy often require structured long-term follow-up to identify digestive dysfunction, glycemic instability, weight loss, and nutrition-related complications. At the same time, advances in diagnostic testing, continuous glucose monitoring, nutritional assessment, body composition analysis, and biomarker-based risk stratification are creating new opportunities for earlier detection and more individualized management. Precision treatment approaches, including optimized pancreatic enzyme replacement therapy, tailored nutritional support, diabetes management strategies, and rehabilitation pathways, are increasingly important to improve outcomes across diverse pancreatic disease settings.This Research Topic welcomes original research, clinical studies, translational work, systematic reviews, meta-analyses, and expert perspectives addressing the metabolic consequences of pancreatic disease and pancreatic surgery. Areas of interest include, but are not limited to, pancreatic exocrine insufficiency and pancreatogenic diabetes; post-surgical nutritional complications; malabsorption, sarcopenia, and cachexia; micronutrient deficiency and bone health; metabolic monitoring after pancreatoduodenectomy, distal pancreatectomy, and total pancreatectomy; biomarkers and imaging tools for functional assessment; precision nutrition and enzyme replacement strategies; and integrated care models for long-term follow-up.By bringing together clinical, nutritional, endocrine, surgical, and translational perspectives, this Research Topic aims to advance understanding of the metabolic burden associated with pancreatic disease and pancreatic intervention. It seeks to support a more precise, patient-centered approach to diagnosis, monitoring, and treatment, with the ultimate goal of improving recovery, survivorship, and long-term metabolic health. Topic editors: Aseem Rai Bhatnagar, Eric C.H. LAI Source: https://www.frontiersin.org/research-topics/80825/metabolic-sequelae-of-pancreatic-disease-and-pancreatic-surgery-exocrine-endocrine-failure-nutrition-and-precision-treatment