Diagnosis of exocrine pancreatic insufficiency in chronic pancreatitis: 13C-Mixed Triglyceride Breath Test versus Fecal Elastase

González-Sánchez, Víctor; Amrani, Rahma; González, Victoria; Trigo, Celia; Picó, Antonio; de-Madaria, Enriqué

doi:10.1016/j.pan.2017.03.002

Cited by 36 publications

(23 citation statements)

References 38 publications

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“…The monoclonal ELISA assay is considered to be more accurate than the polyclonal test for FE-1 [26]. The sensitivity and specificity of FE-1 for diagnosing PI improves when a cut-off concentration of b 128 μg/g stool is utilized [27], with a recent study reporting that 84 μg/g stool has even higher diagnostic accuracy with a sensitivity of 87.5%, specificity of 81.6%, PPV 66.7%, NPV 93.9%, and AUC of 0.861 when compared to 72 h fecal fat estimation [28]. Others note that a level N 100 μg/g stool has a 99% predictive value for the subject not being PI [29].…”

Section: Indirect Testsmentioning

confidence: 99%

Pancreatic insufficiency in Cystic Fibrosis

Singh

Schwarzenberg

2017

Journal of Cystic Fibrosis

154

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Section: Indirect Testsmentioning

confidence: 99%

Pancreatic insufficiency in Cystic Fibrosis

Singh

Schwarzenberg

2017

Journal of Cystic Fibrosis

154

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“…PEI can also be diagnosed with a 13C mixed triglyceride breath test by measuring the concentration of 13CO 2 in expired air after administering the radiolabeled test meal containing a known amount of fat [86]. Its accuracy is similar to FE-1 in diagnosing PEI [87].…”

Section: Diagnosis Of Peimentioning

confidence: 99%

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

et al. 2018

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The exocrine and endocrine pancreata are very closely linked both anatomically and physiologically. Abdominal symptoms such as nausea, bloating, diarrhea, steatorrhea, and weight loss can often occur in diabetic patients. Impairments of the exocrine pancreatic function seem to be a frequent complication of diabetes mellitus; however, they are largely overlooked. The aim of this paper is to provide an overview of the current concepts of exocrine pancreatic insufficiency (PEI) in diabetes mellitus. The prevalence and symptoms of PEI in diabetes mellitus, the pathomechanism, and difficulties of diagnosis and therapy of PEI are summarized in this systematic review.

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“…There are several direct and indirect diagnostic methods for EPI but only the 13C-mixed triglyceride breath test is recommended by the FDA in clinical trials as a gold standard [17]. Recently, González-Sánchez et al found that the diagnostic performance of fecal elastase-1 and 13C-mixed breath test was similar in chronic pancreatitis patients in terms of EPI diagnosis [18]. Beside this recommendation and in the light of this information fecal elastase-1 is still reliable for EPI diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Sleeve gastrectomy relieves exocrine pancreatic insufficiency in morbidly obese patients: a prospective case-control study

Akpınar¹,

Öztürk²,

Murat³

et al. 2019

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Introduction: Bariatric surgery is the most effective treatment modality in morbidly obese patients. Compared to Roux-en Y gastric bypass (RYGB), sleeve gastrectomy (SG) has better metabolic and nutritional outcomes after surgery. Exocrine pancreatic insufficiency (EPI) can be seen after RYGB but there is not any knowledge about EPI-SG association. Aim: To assess exocrine pancreatic functions before and after the SG procedure. Material and methods: This is a single-center, prospective and case-control study. Forty morbidly obese patients were included in the study. Their pre-operative and post-operative, third month fecal samples were collected. Exocrine pancreatic insufficiency was determined by using fecal elastase-1 and diagnosed when fecal elastase-1 levels were < 200 µg/g. Results: The mean fecal elastase-1 level was 256.25 ±137.16 µg/g and the mean post-surgical fecal elastase-1 level was 437.7 ±212.43 µg/g (p = 0.001). In the pre-operative period, half of patients had FE levels under 200 µg/g. In the third month after surgery, only 4 patients had fecal elastase-1 levels under 200 µg/g. Comparison of fecal elastase-1 between pre-surgery and post-surgery revealed a significant difference (p = 0.001). Conclusions: This is the first study to investigate EPI-SG association. Surgery-associated morbidity and mortality are the leading limitations of bariatric surgery procedures. Exocrine pancreatic insufficiency is one of them; prior studies demonstrate its increased frequency after RYGB. Our study revealed that SG relieves exocrine pancreatic insufficiency.

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Diagnosis of exocrine pancreatic insufficiency in chronic pancreatitis: 13C-Mixed Triglyceride Breath Test versus Fecal Elastase

Cited by 36 publications

References 38 publications

Pancreatic insufficiency in Cystic Fibrosis

Pancreatic insufficiency in Cystic Fibrosis

Exocrine pancreatic insufficiency in type 1 and type 2 diabetes mellitus: do we need to treat it? A systematic review

Sleeve gastrectomy relieves exocrine pancreatic insufficiency in morbidly obese patients: a prospective case-control study

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