Abstract
Background: Exocrine pancreatic insufficiency results from the destruction of the pancreatic parenchyma and is diagnosed by using direct or indirect tests, both of which have shortcomings. Chronic pancreatitis is the most frequent cause of this pathology in adults. Methods: Patients meeting radiological or histological diagnostic criteria of chronic pancreatitis are enrolled and the stool elastase test is conducted, considering fecal elastase levels >200 µg/g to represent normal pancreatic function, and levels <200 μg/g to indicate the presence of exocrine pancreatic insufficiency. Additionally, we determine the body mass index of the patients and study their nutritional status and main biochemical and hematological variables, including their glucose and hemoglobin A1c (HbA1c) levels. Results: Exocrine pancreatic insufficiency is detected in 60% of the patients. Among these, 83.3% are severe cases, and 72% of the latter also are diagnosed with endocrine pancreatic insufficiency (diabetes mellitus). During the nutritional status study, HbA1c levels are significantly higher, and magnesium and prealbumin levels are significantly lower in patients with exocrine pancreatic insufficiency than in those without this disease. Conclusions: Exocrine and endocrine pancreatic insufficiency are highly prevalent among patients with chronic pancreatitis and an early diagnosis of these diseases is vital to improve the clinical management of these patients and reduce their risk of mortality.
Highlights
Exocrine pancreatic insufficiency (EPI) results from the destruction of the pancreatic parenchyma with a sufficiently large loss of acinar cells and/or obstruction of pancreatic ducts that it is not possible to maintain the minimum production levels of digestive enzymes and ductal bicarbonate secretion required to adequately digest food [1,2]
We present a cross-sectional study of 50 patients with chronic pancreatitis (CP) under follow-up at San Cecilio University Hospital between February 2015 and June 2016
Inclusion criteria were: age > 18 years; fulfilment of Rosemont diagnostic criteria for Chronic pancreatitis (CP) in patients diagnosed by endoscopic ultrasonography (EUS) [10]; the presence of pancreatic calcifications or dilatation of the main pancreatic duct with parenchymal alterations in those diagnosed by abdominal ultrasound or computed tomography; and a positive histologic result in those diagnosed by pancreatic biopsy
Summary
Exocrine pancreatic insufficiency (EPI) results from the destruction of the pancreatic parenchyma with a sufficiently large loss of acinar cells and/or obstruction of pancreatic ducts that it is not possible to maintain the minimum production levels of digestive enzymes and ductal bicarbonate secretion required to adequately digest food [1,2]. Chronic pancreatitis (CP) is the most frequent cause of EPI in adults [3]. Exocrine pancreatic function is diagnosed by using direct or indirect tests, both of which have shortcomings. Exocrine pancreatic insufficiency results from the destruction of the pancreatic parenchyma and is diagnosed by using direct or indirect tests, both of which have shortcomings. Methods: Patients meeting radiological or histological diagnostic criteria of chronic pancreatitis are enrolled and the stool elastase test is conducted, considering fecal elastase levels >200 μg/g to represent normal pancreatic function, and levels
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