engleski

Screening for Pancreatic Exocrine Insufficiency in Patients with Alcoholic Cirrhosis, Diabetic Patients and Those Recovered from Previous Acute Pancreatitis

Introduction: Fecal-elastase-1 (FE-1) is sensitive and specific indirect test of pancreatic exocrine function. Despite high functional pancreatic reserve some patients with alcoholic cirrhosis, diabetes mellitus (DM) and patients those recovered of acute pancreatitis (AP) by different etiology may have an exocrine function. Objectives: To detect pancreatic exocrine insufficiency in patients with alcoholic cirrhosis, DM and those recovered from earlier AP. Patients and Methods: Seventy-five patients were enrolled (19 alcoholic cirrhosis, 19 DM and 37 recovered from AP). Diagnosis of cirrhosis was based on clinical, biochemical and ultrasonographic findings and alcohol intake (>80 g of ethanol/day for 5 or more years). Patients with DM, on insulin therapy (excluding pancreatic DM), had the disease more than 10 years. Patients recovered from AP (20 billiary, 15 alcoholic pancreatits and 2 unknown cause) had an attack 10 or more years ago. An immunoenzymatic method (ScheBoTech, Wettenburg, Germany) was used for FE-1 evaluation. Moderate pancreatic insufficiency was established when FE-1 was 100-200 microg/g and severe when <100 microg/g. Results: Four alcoholic cirrhosis patients (21%) had FE-1 <100 microg/g and 3 between 100-200 microg/g. Three DM patients (16%) had moderate and 3 (16%) severe pancreatic insufficiency. Four patients recovered from AP (11%) (2 alcoholic, 1 biliary and 1 with other cause of pancreatitis) had FE-1 <100 microg/g and 4 patients (11%) with the same etiology distribution had FE-1 between 100-200 microg/g. Conclusion: FE-1 may serve as a screening tool for underlying pancreatic exocrine insufficiency in alcoholic cirrhosis, diabetes mellitus and patients recovered from AP.

Chronic pancreatitis; exocrine insufficiency; cirrhosis; diabetes mellitus; screening

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