Diagnosis: Functional Testing, Radiological Work-up of Chronic Pancreatitis

Kahl, Matthias; Keller, Jutta; Layer, Peter

doi:10.1007/978-3-540-28656-1_36

Cited by 3 publications

(2 citation statements)

References 89 publications

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“…During the convalescence period 14-100% of patients show abnormal exocrine function confirmed by either direct secretin-pancreozymin or indirect PABA tests [53]. In most patients [96]. If patients present with symptoms of maldigestion as leading symptoms, pancreatic function testing is performed as a first step.…”

Section: Acute Pancreatitismentioning

confidence: 99%

Tests of pancreatic exocrine function – Clinical significance in pancreatic and non-pancreatic disorders

Keller

Aghdassi

Lerch

et al. 2009

Best Practice & Research Clinical Gastroenterology

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Section: Acute Pancreatitismentioning

confidence: 99%

Tests of pancreatic exocrine function – Clinical significance in pancreatic and non-pancreatic disorders

Keller

Aghdassi

Lerch

et al. 2009

Best Practice & Research Clinical Gastroenterology

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“…Оцінку структурного стану ПЗ і печінки проводили за даними УЗД цих органів з визначенням ступеня тяжкості процесу за параметрами Марсельсько-Кембриджської класифікації ХП, оцінюючи в один бал такі патологічні ознаки: розширення вірсунгової протоки понад 3 мм, внутрішньопротокові ехогенні утворення (камені, кальцинати); зони зниженої ехогенності з дрібними (1-3 мм) включеннями (запальний тканинний набряк); гіперехогенні включення (кальцифікація залози); лінійні тяжисті включення (фіброз); нерівний контур залози (фіброз і атрофія залози); анехогенні порожнини (розмірами понад 5 мм) -наявність псевдокіст [32][33][34].…”

Section: характеристики стану підшлункової залози й печінки при хроні...unclassified

Characteristics of the pancreas and liver state in chronic pancreatitis on the background of treated chronic viral hepatitis C depending on the international CAGE questionnaire testing results

Бабинец

KHOMYN

Halabitska

2023

GASTRO

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Background. It was found that in 35–56 % of patients, hepatobiliary diseases are considered to be a factor causing the formation or exacerbation of chronic pancreatitis (CP) while reducing the share of pancreatitis of alcoholic etiology, as it was previously believed. However, the role of the alcohol factor and its consideration in the treatment strategy for CP and comorbidity with chronic viral hepatitis C (HCV) also needs to be clarified, because it is known that excessive alcohol consumption and smoking increases the risk of developing pancreatitis by 8–17 times. The purpose is to conduct a comparative analysis of parameters of the structural and functional state of the liver and pancreas in patients with chronic pancreatitis associated with chronic viral hepatitis C treated etiotropically, depending on the results of testing according to the international CAGE questionnaire. Materials and methods. We have examined 100 ambulatory patients with CP and concomitant HCV, treated etiotropically. All patients were examined according to generally accepted algorithms. To clarify the effect of alcohol on the formation of CP and the state of patients with treated HCV, latent craving for alcohol was verified using the international CAGE questionnaire. The study on the density of the liver parenchyma and the pancreas was carried out not only according to the ultrasound data in the B-mode, but also with the simultaneous shear wave elastography on the Ultima PA scanning ultrasound device with the further measurement of the median of the parameters in kilopascals. Determination of the presence and depth of exocrine pancreatic insufficiency was carried out by the content of fecal elastase-1 evaluated using the enzyme immunoassay method. Results. Screening-testing of patients with CP on the background of HCV treated etiotropically using the CAGE scale made it possible to state that 65.0 % of them had a latent craving for alcohol, and 21.0 % of this cohort were women, which needs to be taken into account in the management of such patients. It has been proven that in the group with CAGE ≥ 2.0, functional and structural changes in the liver and pancreas were significantly more severe (deepening of the exocrine pancreatic insufficiency with a decrease in fecal α-elastase by 13.01 %, an increase in the total index of the coprogram by 15.11 % and the total ultrasound indicator of the pancreatic structure by 28.06 %, and the total ultrasound indicator of the liver structure by 40.68 % (р < 0.05)) and corresponded to the average degree of severity of the process in the pancreas according to the criteria of the Marseille-Cambridge classification, and in the group with CAGE < 2.0 — only to a mild degree. Conclusions. The negative effect of the factor of increased alcohol use according to the CAGE was proven by increased density of pancreatic echotexture by 5.73 % (p < 0.05), and of the hepatic echotexture by 5.16 % (p < 0.05). According to the results of the correlation analysis on the dependence of the structural state of the liver and pancreas on the CAGE score, which were R = 0.713, p < 0.05, and R = 0.686, p < 0.05, respectively, there was found a strong direct dependence of the structural state of the liver and pancreas on the CAGE score, which proved an independent, reliably significant role of alcohol consumption for patients with a comorbid course of CP and HCV.

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