Indirect diagnosis of pancreatic exocrine insufficiency (PEI) in chronic pancreatitis (CP) by endoscopic ultrasound (EUS)-guided elastographic quantification of pancreatic fibrosis: A prospective observational study

Abstract

s / Pancreatology 13 (2013) S2–S98 S75 b)When comparedwith abstainers, heavy drinker intake is a risk factor to develope CP (p1⁄40,038; O.R1⁄42,583) c) Pancreas divisum is a risk factor to develope ARP (p1⁄40,000; O.R1⁄410,533) but not CP. d) Moderate alcohol intake is not statistically significant in both ARP and CP. Conclusion: Heavy alcohol consumption and smoking inhabits are independent risks for CP. Pancreas divisum is a risk factor to develope ARP. PII-75 Abstract id: 197. Covered self-expanding metal stents (CSEMS) may offer improved clinical success compared to multiple plastic stents (PS) in strictures secondary to chronic pancreatitis: A systematic review and metaanalysis Antti Siiki , Mika Helminen , Juhani Sand , Johanna Laukkarinen . Dept. of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland 2 Science Center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere, Finland Introduction: CSEMS are being increasingly used in the endoscopic treatment of benign biliary strictures (BBS). Despite promising results, there is not yet solid evidence to support their routine use. Aims: To evaluate feasibility of CSEMS compared to PS in BBS in terms of clinical success and complications. Materials & methods: A systematic search of Medline, Scopus and Embase database for studies published 2000-2012 combined to handsearch of reference lists resulted 4977 articles. Out of 99 potentially relevant studies selected for full-text review, 12 CSEMS (376 patients) and 13 PS studies (570 patients) met the final inclusion criteria. A systematic review was made using proportion meta-analysis. Results: A tendency to successful use of CSEMS in strictures related to chronic pancreatitis (CP) was shown: clinical success of 77% and 33% (95% CI 61-94% vs. 4-63%, p1⁄40.06) was achieved with CSEMS and PS at 12 months follow-up, respectively. There were no differences in the success rates of other etiologies except CP or in the early complications. In CSEMS, incidence of late adverse events was lower in CP related strictures (3% vs. 67%, 95%CI 0-13% vs. 17-99%, p1⁄40.02). The median number of ERCPs was lower with CSEMSs (1.5 vs. 3.9, p1⁄40.002). Conclusion: Improved clinical success with fewer endoscopic sessions and corresponding complication rate may be achieved with CSEMS compared to PS in BBS secondary to chronic pancreatitis. PII-76 Abstract id: 182. Indirect diagnosis of pancreatic exocrine insufficiency (PEI) in chronic pancreatitis (CP) by endoscopic ultrasound (EUS)-guided elastographic quantification of pancreatic fibrosis: A prospective observational study J. Enrique Dominguez-Mu~ noz , Margarita Casti~ neira-Alvari~ no , Maria Luaces-Regueira , Jos e Lari~ no-Noia , Laura Nieto-Garcia , Julio IglesiasGarcia . University Hospital of Santiago. Foundation for Research in Digestive Diseases, Spain 2 Foundation for Research in Digestive Diseases, Spain Introduction: Diagnosis of PEI is hindered by methodological difficulties of pancreatic function tests. The probability of PEI increases as fibrosis develops. Pancreatic fibrosis in CP can be quantified by EUS-guided elastography. Aims:We aimed at evaluating if pancreatic elastography can be used to predict PEI in patients with CP. Materials & methods: Prospective observational study including patients consecutively diagnosed with CP based on EUS ( 5 criteria) and/or s-MRCP findings. PEI was diagnosed by 13C-mixed triglyceride breath test and defined as a 13C-cumulative recovery rate 5.5). Conclusion: The degree of pancreatic fibrosis as measured by EUSguided elastography allows quantifying the probability of PEI, and thus the need for oral pancreatic enzyme therapy, in patients with CP PII-77 Abstract id: 296. Morphological features of pancreatic cystic lesions in endoscopic ultrasonography (EUS) examination – A single-center experience Malgorzata Degowska, Marek Stobinski, Janusz Milewski, Grazyna