The role of fecal elastase-1 in detecting exocrine pancreatic disease

Summary: Pancreatic cysts have been detected ever more frequently in recent years due to the advanced and wider use of imaging methods. We find them on CT or MR also in asymptomatic patients who do not have a history of any pancreatic disease. Pancreatic cystic lesions represent a wide range of pathological changes from simple cysts through precancerous lesions to malignant cysts. Accurate diagnosis remains difficult despite the combination of clinical status evaluation, imaging findings, and biochemical and cytological examination. Molecular biological examination of cyst aspirate obtained by endosonographic examination increases the detection rate of mucinous cysts (KRAS/GNAS/VHL) and cysts with a high risk of malignancy (KRAS/GNAS/p53/PIK3CA/PTEN/CDKN2A/SMAD4) and optimizes therapeutic approach. Larger prospective validation studies are necessary to make this costly and limited method a routine part of clinical practice. Key words: molecular biology – neoplasia – pancreatic cysts

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Serum Elastase 1 and Immunoreactive Trypsin in Chronic Pancreatic Disease: Is There Any Relationship with Trypsin Inhibitors?

Enzyme ◽

10.1159/000469326 ◽

1986 ◽

Vol 35 (2) ◽

pp. 82-86 ◽

Cited By ~ 3

Author(s):

C. (a) Fabris ◽

G. (a) Del Favero ◽

A. (a) Panucci ◽

M (b) Plebani ◽

F. (a) Di Mario ◽

...

Keyword(s):

Pancreatic Disease ◽

Trypsin Inhibitors ◽

Immunoreactive Trypsin ◽

Elastase 1

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Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1

Gastroenterology Research and Practice ◽

10.1155/2019/5290642 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Mazen Shobassy ◽

Nedaa Husainat ◽

Abdalaziz Tabash ◽

Kalpesh Patel ◽

Hashem B. El-Serag ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Endoscopic Ultrasound ◽

Pancreatic Insufficiency ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Exocrine Pancreatic Insufficiency ◽

Cross Sectional ◽

Fecal Elastase ◽

Elastase 1 ◽

Pancreatic Neoplasia

Background and Aims. Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound (EUS) findings for patients with low FE-1. Methods. A retrospective cross-sectional study was performed in 40 patients who had low FE-1 and underwent EUS to evaluate the pancreas. We obtained data on demographic and lifestyle factors, EUS findings, and histopathology results. We compared these variables between patients with FE‐1<100 mcg/g vs. 100-200 mcg/g. Results. Most patients (82.5%) established one or more new diagnoses from EUS. Diagnoses included: definitive chronic pancreatitis (n=29, 72.5%), fatty pancreas (n=9, 22.5%), and pancreatic solid mass or cyst (n=9, 22.5%). Half (n=4) of the solid or cystic lesions were neoplastic. All patients with a solid pancreatic mass also had concurrent chronic pancreatitis. There were no significant differences in EUS findings or demographic or lifestyle factors between groups with FE‐1<100 mcg/g vs. 100-200 mcg/g. Conclusion. Chronic pancreatitis is the most common EUS finding in patients with low FE-1 levels. EUS appears helpful in determining the cause of EPI in most patients with low FE-1 and may detect unsuspected pancreatic neoplasia.

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Current Role of ERCP in the Management of Benign Pancreatic Disease

Endoscopy ◽

10.1055/s-2007-1010449 ◽

1992 ◽

Vol 24 (01/02) ◽

pp. 120-124 ◽

Cited By ~ 7

Author(s):

N. J. Parikh ◽

J. E. Geenen

Keyword(s):

Pancreatic Disease ◽

Current Role

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Abstract A27: Exploring the role of glycosylation in pancreatic disease

10.1158/1538-7445.mousemodels17-a27 ◽

2018 ◽

Author(s):

Dannielle Engle ◽

Hervé Tiriac ◽

Arnaud Pommier ◽

Christina Schoepfer ◽

Brandon Da Silva ◽

...

Keyword(s):

Pancreatic Disease

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The Role of Interventional Radiology in the Management of Pancreatic Pathologies

Journal of Gastrointestinal and Abdominal Radiology ◽

10.1055/s-0039-3401335 ◽

2020 ◽

Vol 3 (01) ◽

pp. 099-113

Author(s):

Ghali Salahia ◽

Sook Cheng Chin ◽

Ian Zealley ◽

Richard D. White

Keyword(s):

Multidisciplinary Approach ◽

Irreversible Electroporation ◽

Vascular Complications ◽

Percutaneous Biopsy ◽

Pancreatic Disease ◽

Percutaneous Radiofrequency Ablation ◽

Image Guided ◽

Ablative Techniques ◽

Effective Diagnosis

AbstractPancreatic pathologies are varied and wide-ranging, and a multidisciplinary approach is essential for effective diagnosis and management. We describe image-guided percutaneous (nonendoscopic) interventions in the management of pancreatic disease, with emphasis on inflammatory and neoplastic pancreatic pathologies and on the transplanted pancreas. Image-guided treatments for the complications of pancreatitis include percutaneous interventions on simple and complex peripancreatic collections, pseudocysts, and fistulas. Vascular interventions predominantly focus on the treatment of pseudoaneurysms, hemorrhagic pseudocysts, and arteriovenous malformations. Emerging ablative techniques for pancreatic cancer are promising and include percutaneous radiofrequency ablation, microwave ablation, irreversible electroporation, and electrochemotherapy. Image-guided interventions on the transplanted pancreas commonly include percutaneous biopsy and drainage in addition to endovascular treatments of vascular complications.

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