727 EXOCRINE PANCREATIC INSUFFICIENCY AFTER ESOPHAGECTOMY: A SYSTEMATIC REVIEW OF LITERATURE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lotte Blonk ◽  
N J Wierdsma ◽  
E P Jansma ◽  
G Kazemier ◽  
D L Peet ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Pancreatic Function ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Fecal Fat ◽  
Effect Of Treatment

Abstract   Complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are often attributed to an impaired exocrine pancreatic function. This review systematically summarizes all literature reporting on the presence of exocrine pancreatic insufficiency (EPI) after esophagectomy and the effect of treatment with pancreatic enzymes on gastrointestinal complaints, body weight, and quality of life. Methods Databases of PubMed, Embase, and Wiley/Cochrane Library were searched systematically until July 2020. Studies reporting on EPI and pancreatic enzyme replacement therapy after esophagectomy were included. Results Four studies, including 158 patients, were selected. Exocrine pancreatic function was investigated in three studies, measured by fecal elastase-1 and 72-hour fecal fat excretion. Fecal elastase-1 levels <200 μg/g were reported in 16% of patients at 4 months, 18% at 6 months, and 31% at 18-24 months postoperatively. A decreased fecal fat absorption was noticed in 57% 1 month postoperatively. Treatment with pancreatic enzymes was reported in two studies. In patients with fecal elastase-1 levels <200 μg/g, 90% of patients reported improvement in symptoms and 70% reported improvement in weight. In patients with complaints of steatorrhea, 87% noticed settlement of symptoms. Conclusion Based on current literature, complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are common and can be related to an impaired exocrine pancreatic function. High-quality studies evaluating the presence of EPI and the effect of treatment with pancreatic enzymes after esophagectomy are needed to verify this conclusion.

Exocrine pancreatic insufficiency after esophagectomy: a systematic review of literature

2021 ◽  
Author(s):  
L Blonk ◽  
N J Wierdsma ◽  
E P Jansma ◽  
G Kazemier ◽  
D L van der Peet ◽  
...  
Keyword(s):  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Enzymes ◽  
Pancreatic Function ◽  
Study Quality ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Fecal Fat ◽  
Effect Of Treatment

Summary Complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are often attributed to an impaired exocrine pancreatic function. This review systematically summarizes all literature reporting on the presence of exocrine pancreatic insufficiency (EPI) after esophagectomy and the effect of treatment with pancreatic enzymes on gastrointestinal complaints, body weight, and quality of life. Databases of PubMed, Embase, and Wiley/Cochrane Library were searched systematically until July 2020. Studies reporting on EPI and pancreatic enzyme replacement therapy after esophagectomy were included. The Newcastle–Ottawa scale was used to assess study quality. Four studies, including 158 patients, were selected. The maximum score for study quality was six (range 4–6). Exocrine pancreatic function was investigated in three studies, measured by fecal elastase-1 and 72-hour fecal fat excretion. Fecal elastase-1 levels <200 μg/g were reported in 16% of patients at 4 months, 18% at 6 months, and 31% at 18–24 months postoperatively. A decreased fecal fat absorption was noticed in 57% 1 month postoperatively. Treatment with pancreatic enzymes was reported in two studies. In patients with fecal elastase-1 levels <200 μg/g, 90% of patients reported improvement in symptoms and 70% reported improvement in weight. In patients with complaints of steatorrhea, 87% noticed settlement of symptoms. Based on current literature, complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are common and can be related to an impaired exocrine pancreatic function. High-quality studies evaluating the presence of EPI and the effect of treatment with pancreatic enzymes after esophagectomy are needed to verify this conclusion.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
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.

scholarly journals W1677 Diagnostic of Exocrine Pancreatic Insufficiency - Fecal Elastase-1 vs. serum-beta-Carotin

2010 ◽  
Vol 138 (5) ◽  
pp. S-901
Author(s):  
Dominique Suelberg ◽  
Johanna Krause ◽  
Orlin Belyaev ◽  
Ansgar M. Chromik ◽  
Waldemar Uhl
Keyword(s):  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Fecal Elastase ◽  
Elastase 1

scholarly journals Method Performance of Bicarbonate and Electrolytes by Use of Duodenal Fluid for Assessment of Exocrine Pancreatic Function

2018 ◽  
Vol 3 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Amy Pyle-Eilola ◽  
Jill Pagan ◽  
Adam Kayatin ◽  
Patrick N Povse ◽  
Jacqua A Rietschlin ◽  
...  
Keyword(s):  
Limit Of Detection ◽  
Pancreatic Insufficiency ◽  
Method Comparison ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Function ◽  
Stability Studies ◽  
Method Performance ◽  
Sodium Potassium ◽  
Duodenal Fluid

Abstract Background Evaluation of exocrine pancreatic insufficiency is challenging for both clinicians and laboratories. Indirect pancreatic function tests such as serum trypsinogen, fecal elastase, and fecal fat measurements are moderately sensitive for diagnosis of advanced chronic pancreatitis but show reduced sensitivity and specificity for diagnosis of early disease. An alternative is the endoscopic pancreatic function test, which uses duodenal secretions after administration of IV secretin. Samples are collected at various times via the endoscopic tube and then analyzed for bicarbonate, sodium, potassium, and chloride. Methods Precision, linearity, method comparison, and stability studies were performed on the Beckman Coulter AU5822 chemistry analyzer with duodenal fluid. Comparison with the Vitros 4600 dry slide chemistry instrument was used to interrogate differences between methods. Results All assays produced a CV &lt;2% without any measurable effects from the endoscopy fluid matrix and showed acceptable imprecision near the limit of detection (CV &lt; 5%). All analytes showed linear dilution across the analytical measuring range. All the calculated error biases from dilutions were within 50% of the CLIA-allowable error for serum for each of the respective analytes. The calculated slopes ranged from 0.841 to 1.274 when compared to the Vitros 4600. Stability studies demonstrated that sodium, potassium, chloride, and bicarbonate remained stable after storage at −20 °C and after multiple freeze–thaw cycles. The percent change for all analytes was &lt;5% mmol/L. Conclusions The AU5800 series demonstrated adequate performance for the analysis of bicarbonate in duodenal fluid and therefore can be used for assessment of exocrine pancreatic function. However, notable discrepancies were observed for sodium, potassium, and chloride between the AU5800 series and the Vitros 4600.

Comparison of fecal lipase test and fecal elastase-1 test in the assessment of exocrine pancreatic function in cystic fibrosis

2003 ◽  
Vol 124 (4) ◽  
pp. A517
Author(s):  
Jaroslaw Walkowiak ◽  
Karl-Heinz Herzig ◽  
Krystyna Strzykala ◽  
Juliusz Przyslawski ◽  
Marian Grzymislawski ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Exocrine Pancreatic Function ◽  
Pancreatic Function ◽  
Fecal Elastase ◽  
Elastase 1

Tu1457 Diagnostic Utility of Fecal Elastase-1 in Exocrine Pancreatic Insufficiency - A Systematic Review and Meta-Analysis

2016 ◽  
Vol 150 (4) ◽  
pp. S906
Author(s):  
Rohini R. Vanga ◽  
Aylin Tansel ◽  
Avinash G. Ketwaroo ◽  
Hashem B. El-Serag ◽  
Mohamed O. Othman
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Diagnostic Utility ◽  
Fecal Elastase ◽  
Elastase 1
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