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 COMPARISON OF FECAL ELASTASE 1 FOR EXOCRINE PANCREATIC INSUFFICIENCY EVALUATION BETWEEN EX-ALCOHOLICS AND CHRONIC PANCREATITIS PATIENTS

2014 ◽  
Vol 51 (4) ◽  
pp. 297-301 ◽  
Author(s):  
Rejane MATTAR ◽  
Gustavo André Silva LIMA ◽  
Marianges Zadrozny Gouvêa da COSTA ◽  
Joyce M Kinoshita SILVA-ETTO ◽  
Dulce GUARITA ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Predictive Value ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Exocrine Insufficiency ◽  
Exocrine Insufficiency ◽  
Noninvasive Test ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Pancreatic Exocrine

Context Fecal elastase is a noninvasive test for pancreatic insufficiency diagnosis. Objectives Evaluate the usefulness of fecal elastase 1 for the indication of exocrine pancreatic insufficiency among former alcohol addicts and patients with chronic pancreatitis. Methods Forty-three patients with chronic pancreatitis and thirty-three asymptomatic former alcohol addicts entered the study. The levels of fecal elastase 1 were measured using a commercial kit. Pancreatic imaging findings were used to categorize the groups. Results The levels of fecal elastase 1 were significantly lower in the patients than in the former alcohol addicts and in the group with tissue calcifications, duct alterations, or atrophy. With a cutoff level of 100 μg/g, the sensitivity of fecal elastase 1 in chronic pancreatitis was 46.51% and its specificity was 87.88% with a positive predictive value of 83.33% and a negative predictive value of 55.77%. When patients were stratified according to the severity of their pancreatitis, the sensitivity was 6.25% for mild pancreatitis and 70.37% for marked pancreatitis. Conclusion Low level of fecal elastase 1 was associated with marked rather than mild chronic pancreatitis; however, it may be useful to indicate pancreatic exocrine insufficiency in asymptomatic former alcohol addicts.

scholarly journals Defining the endoscopic ultrasound features of chronic pancreatitis in Asians: a multicenter validation study

Endoscopy ◽  
2020 ◽  
Author(s):  
Calvin Jianyi Koh ◽  
Sundeep Lakhtakia ◽  
Mitsuhiro Kida ◽  
Cosmas Rinaldi A. Lesmana ◽  
Tiing Leong Ang ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Ultrasound ◽  
Main Pancreatic Duct ◽  
Cross Sectional Study ◽  
Cancer Surveillance ◽  
Receiver Operating Curve ◽  
Cross Sectional ◽  
Multicenter Prospective Study ◽  
Ultrasound Features

Background Although endoscopic ultrasound (EUS) features and criteria have been described in chronic pancreatitis, challenges remain with interoperator variability and ease of adoption. The aim of this study was to define and validate the EUS features of chronic pancreatitis in a multicenter prospective study in Asia. Method The study was divided into two parts: the first part was conducted to derive the EUS features of chronic pancreatitis with adequate interoperator agreement; the second was to prospectively evaluate these features in a multicenter cross-sectional study and determine the optimal combination of features for the diagnosis of chronic pancreatitis. Prospectively enrolled cases had standard internationally validated radiologic or histologic features of chronic pancreatitis, and controls were patients without chronic pancreatitis who underwent EUS examination. Results The top six EUS features that had good interobserver agreement (mean kappa 0.73, range 0.60 – 0.90) were selected to be further evaluated in part II of the study. These included: hyperechoic foci with shadowing, lobularity with honeycombing, cysts, dilated main pancreatic duct, dilated side branches, and calculi in the main pancreatic duct. A total of 284 subjects (132 cases, 152 controls) were enrolled from 12 centers in Asia. All six features had high accuracy ranging from 63.3 % to 89.1 %. Two or more of these six EUS features accurately defined chronic pancreatitis (sensitivity 94.7 %, specificity 98.0 %), with an area under the receiver operating curve of 0.986. Conclusion This multicenter Asian study characterized and defined the EUS features of chronic pancreatitis. This provides a useful tool in clinical practice and further research in pancreatic cancer surveillance.

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

Do endoscopic ultrasound provides information in evaluating exocrine pancreatic insufficiency in chronic pancreatitis?

Pancreatology ◽  
2013 ◽  
Vol 13 (4) ◽  
pp. e16
Author(s):  
F.M. Fernández Cano ◽  
M.A. Romero Ordóñez ◽  
M. González Bárcenas ◽  
R. Rivera Irigoin ◽  
M.C. López Vega ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency

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 &lt;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 &lt;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.

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 &lt;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 &lt;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.

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