scholarly journals News of European Pancreatology (based on the materials of the 52nd meeting of the European Pancreatic Club)

2020 ◽  
Vol 49 (4) ◽  
pp. 6-20
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
L. A. Yaroshenko ◽  
A. Ye. Klochkov ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Exocrine Function ◽  
Anatomical Variants ◽  
Enzyme Replacement ◽  
Pancreatic Pathology ◽  
Pancreatic Steatosis

The 52nd meeting of the European Pancreatic Club was organized and conducted online in Paris on July 2–3, 2020. It is the first time the Congress took place online, with about a thousand of pancreatologists having participated in it. The high scientific, organizational and technical level of the congress should be noted. This review presents the most interesting research results in the following sections: anatomy of the pancreas, acute early chronic, autoimmune pancreatitis, cancer and other malignant pancreatic diseases, functional pancreatic insufficiency, enzyme replacement therapy, pancreatic steatosis, microbiota in pancreatic pathology. Dugic et al. (Sweden) conducted a systematic review “The effect of anatomical variants of the Wirsung’s duct on exocrine function and risk of pancreatic pathology”. Studies of the MEDLINE database from 1960 to 2019 were analyzed; data of 3234 patients were included. A classification of anatomical variants of the pancreatic duct system was compiled. A lecture by T. B. Gardner (Great Britain) on pancreatic steatosis drew great attention. The problem of pancreatic steatosis is surrounded by a number of unresolved issues; the terminology of pancreatic steatosis itself is unclear. Under conditions of oxidative stress, cytokines released from adipocytes trigger the local inflammation and dysfunction of the affected pancreatic cells. The pathogenesis of pancreatic steatosis requires further studies. The symposium on exocrine pancreatic insufficiency in pancreatic cancer played the central role in the congress. Professor E. Dominguez-Munoz (Spain) gave a lecture within the framework of the symposium. 80% of patients with pancreatic cancer have sarcopenia and/or cachexia. Sarcopenia and cachexia in pancreatic adenocarcinoma are the most obviousamong all tumor localizations. The pathogenesis of cachexia and sarcopenia in pancreatic cancer was analyzed in detail; the necessity of enzyme replacement therapy with Creon was substantiated. Particular attention was paid to the pathogenesis of pancreatic insufficiency after surgical treatment (pancreatic resections, pancreatectomy); the features of replacement therapy were highlighted. The meeting of the European Pancreatic Club, as usual, was informative and interesting

scholarly journals Evidence-based pancreatology 2018 (review of research results on diseases and exocrine pancreatic insufficiency)

2019 ◽  
Vol 43 (2) ◽  
pp. 4-14
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
A. Ye. Klochkov ◽  
G. M. Lukashevich ◽  
P. G. Fomenko ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Bacterial Overgrowth ◽  
Exocrine Pancreatic Insufficiency ◽  
Pancreatic Tumors ◽  
Research Results ◽  
Enzyme Replacement ◽  
Pancreatic Pathology

The article presents a detailed review of the research results in the field of pancreatology published in 2018. Certain parts of the review are devoted to the pathogenesis, diagnostics, course of pancreatitis, its treatment, as well as autoimmune, hereditary pancreatitis, pancreatic pathology in children, as well as treatment. In studying the pathogenesis of pancreatitis, attention is paid to genetic markers of pancreatitis along with a role of bacterial overgrowth syndrome in the small intestine, both in terms of worsening of the course of pancreatitis and the lack of effectiveness of enzyme replacement therapy. The study of the role of alcohol abuse and smoking in the pathogenesis of pancreatic pathology is still in progress. Diagnostics is going on. Endosonography remains the most informative method. A number of studies have been devoted to the studying of exocrine and endocrine pancreatic insufficiency both upon pancreatitis, pancreatic tumors, and in functional dyspepsia and HIV infection. Autoimmune pancreatitis is increasingly being diagnosed, a number of studies are devoted to its diagnostics and treatment. Pancreatic diseases in children develop mainly on the background of genetic predisposition, while functional pancreatic insufficiency occurs in adult patients. The study of the peculiarities of the effect of enzyme replacement therapy continues. The immediate and remote results of the surgical treatment of pancreatic pathology are assessed.

Romanian Guidelines on the Diagnosis and Treatment of Exocrine Pancreatic Insufficiency

2015 ◽  
Vol 24 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Cristian Gheorghe ◽  
Andrada Seicean ◽  
Adrian Saftoiu ◽  
Marcel Tantau ◽  
Eugen Dumitru ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Clinical Symptoms ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Exocrine Pancreatic Insufficiency ◽  
Exocrine Function ◽  
Enzyme Replacement ◽  
Pancreatic Enzyme Replacement Therapy ◽  
Enteric Coated

In assessing exocrine pancreatic insufficiency (EPI), its diverse etiologies and the heterogeneous population affected should be considered. Diagnosing this condition remains a challenge in clinical practice especially for mild-to-moderate EPI, with the support of the time-consuming breath test or the coefficient of fat absorption. The fecal elastase-1 test, less precise for the diagnosis, cannot be useful for assessing treatment efficacy. Pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment, whereby enteric-coated mini-microspheres are taken with every meal, in progressive doses based on an individual's weight and clinical symptoms. The main indication for PERT is chronic pancreatitis, in patients who have clinically relevant steatorrhea, abnormal pancreatic function test or abnormal function tests associated with symptoms of malabsorption such as weight loss or meteorism. While enzyme replacement therapy is not recommended in the initial stages of acute pancreatitis, pancreatic exocrine function should be monitored for at least 6-18 months. In the case of unresectable pancreatic cancer, replacement enzyme therapy helps to maintain weight and improve overall quality of life. It is also indicated in patients with celiac disease, who have chronic diarrhea (in spite of gluten-free diet), and in patients with cystic fibrosis with proven EPI.

scholarly journals Pancreatic steatosis: a giant step forward or recognition of ignorance

2020 ◽  
Vol 49 (4) ◽  
pp. 21-41
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
T. L. Mozhyna ◽  
N. E. Monogarova ◽  
K. N. Borodiy ◽  
...  
Keyword(s):  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Fatty Infiltration ◽  
Exocrine Pancreatic Insufficiency ◽  
Point Of View ◽  
Alcoholic Fatty Liver ◽  
Enzyme Replacement ◽  
Fatty Replacement ◽  
Pancreatic Steatosis

This review analyzes the terminology of pancreatic steatosis, the data about the prevalence of non-alcoholic fatty pancreas disease (NAFPD) were given. The etiological factors of NAFPD are usually subdivided into hereditary, metabolic, and toxic ones. The main etiopathogenetic factor of pancreatic fatty infiltration is obesity: it causes pancreatic infiltration by adipocytes, leading to the development of NAFPD. The pathogenesis of the disease is associated with adipocytic tissue dysfunction, which induces local and systemic inflammatory response with corresponding clinical consequences. Insulin resistance and oxidative stress play major role in the pathogenesis of NAFPD. From a histological point of view, NAFPD is a heterogeneous process, characterized by excessive intracellular accumulation of lipids and fatty infiltration followed by fatty replacement of the pancreas. NAFPD clinical picture is asymptomatic and nonspecific. Diagnosis of NAFPD is based primarily on the results of imaging methods (ultrasound, CT, MRI). A consequence of NAFPD is exocrine pancreatic insufficiency requiring enzyme replacement therapy. One of the NAFPD complications is the development of pancreatic adenocarcinoma. Currently, standards for the diagnosis, treatment and management of patients with NAFPD have not been developed yet, but on used the guidelines for the treatment of non-alcoholic fatty liver disease (rational diet, exercises, weight loss). The “gold standard” of enzyme replacement therapy, such as Creon®, is used for correction of exocrine pancreatic insufficiency. The detailed analysis of the clinical case of total pancreatic steatosis with severe exocrine pancreatic insufficiency was done in this article.

scholarly journals Enzyme replacement therapy, life quality and expectancy of patients with chronic pancreatitis and exocrine pancreatic insufficiency

2018 ◽  
Vol 41 (3) ◽  
pp. 10-16
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
А. Y. Klochkov ◽  
G. М. Lukashevich ◽  
P. G. Fomenko ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Life Quality ◽  
Exocrine Pancreatic Insufficiency ◽  
Enzyme Preparations ◽  
Enzyme Replacement ◽  
Enteric Coated ◽  
Adequate Dosage

The article reviews the evidence-based studies devoted to the evaluation of the efficacy and safety of enzyme replacement therapy in patients with chronic pancreatitis with exocrine pancreatic insufficiency. Particular attention is paid to the effect of replacement therapy on the life quality and expectancy of patients. It has been proven that the correct prescription of enzyme preparations (minimicrosphere enteric-coated preparation, adequate dosage) improves the quality and prolongs the life of patients.

Chronic giardiasis: a rare cause of exocrine pancreatic insufficiency

2021 ◽  
Vol 14 (5) ◽  
pp. e242129
Author(s):  
Prateek Pophali ◽  
Maedeh Veyseh ◽  
Omar Fraij ◽  
Sahan Hapangama
Keyword(s):  
Clinical Practice ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Exocrine Pancreatic Insufficiency ◽  
Common Condition ◽  
Enzyme Replacement ◽  
Malabsorption Syndromes ◽  
Pancreatic Enzyme Replacement Therapy

Exocrine pancreatic insufficiency (EPI) is a major cause of maldigestion/malabsorption syndromes. It is routinely diagnosed in clinical practice with the use of faecal elastase 1 levels, and pancreatic enzyme replacement therapy continues to be the mainstay of treatment. Numerous primary pancreatic and extrapancreatic causes for EPI have been established. Chronic giardiasis is a common condition with symptoms similar to EPI; however, it has also been described as an infrequent cause of EPI. Much remains to be understood about the pathobiology of this association. Here, we present our experience of an intriguing case of severe pancreatic insufficiency in the setting of chronic giardiasis. The patient showed improvement in symptoms over weeks after completion of treatment for chronic giardiasis.

Sign in / Sign up

Export Citation Format

Share Document