Pancreatic Insufficiency

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Eddy Robberecht - One of the best experts on this subject based on the ideXlab platform.

  • Transient exocrine Pancreatic Insufficiency as a possible complication of an enterovirus infection
    European Journal of Pediatrics, 2003
    Co-Authors: Stephanie Van Biervliet, Kathleen De Waele, Myriam Van Winckel, Eddy Robberecht
    Abstract:

    Exocrine Pancreatic Insufficiency is an exceptional problem in children, mostly associated with diseases like cystic fibrosis, Shwachman-Diamond syndrome or chronic pancreatitis, as is the case in idiopathic fibrosing pancreatitis. Many viral infections are known to cause acute pancreatitis. Most of them, however, are transient with no remaining damage. The differential diagnosis of persisting diarrhoea after gastrointestinal infection does not routinely include a search for exocrine Pancreatic Insufficiency. Conclusion: This is the first description of a child with a transient but severe exocrine Pancreatic Insufficiency probably induced by an ordinary enterovirus infection

  • Detection and follow up of exocrine Pancreatic Insufficiency in cystic fibrosis: a review.
    European journal of pediatrics, 2000
    Co-Authors: Jasmine Leus, Stephanie Van Biervliet, Eddy Robberecht
    Abstract:

    Pancreatic function testing is particularly difficult when the degree of remaining function has to be quantified. Detection of Pancreatic Insufficiency can suggest the diagnosis of cystic fibrosis (CF). It is, however; also important to follow the degree of Pancreatic Insufficiency in CF since its function can decline with age. Adaptation of Pancreatic enzyme replacement therapy on residual function is necessary. Different tests with their advantages and disadvantages are critically reviewed in this article with respect to specificity, sensitivity, performance and cost-effectiveness. Conclusion Elastase-1 detection in faeces is probably the easiest test for the detection of Pancreatic Insufficiency in cystic fibrosis. For clinical follow-up tests, measuring the fat assimilation such as steatocrit and breath tests are more suited.

Zhihui Tong - One of the best experts on this subject based on the ideXlab platform.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis: long-term follow-up study
    Bulletin of the Club of Pancreatologists, 2018
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Introduction. Patients could develop endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of endocrine Pancreatic Insufficiency through a long-term follow-up investigation. Methods. Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the Pancreatic morphology and the other related data during hospitalization was also collected. Results. One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine Pancreatic Insufficiency with 100μg/g<FE-1<200μg/g and 7 patients (6.2%) were diagnosed with severe exocrine Pancreatic Insufficiency with FE-1<100μg/g. The morbidity of DM and IGT in patients with Pancreatic necrosis was significant higher than that in the non-Pancreatic necrosis group (χ2 = 13.442,P = 0.001). The multiple logistic regression analysis showed that extent of Pancreatic necrosis<30% (P = 0.012, OR = 0.061) were the protective factors of endocrine Pancreatic Insufficiency. HOMA-IR (P = 0.002, OR = 6.626), Wall-off necrosis (WON) (P = 0.013, OR = 184.772) were the risk factors. Conclusion. The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine Pancreatic Insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine Pancreatic Insufficiency, respectively. The extent of Pancreatic necrosis>50%, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.

  • Endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis: long-term follow-up study
    BMC gastroenterology, 2017
    Co-Authors: Jingzhu Zhang, Yue Yang, Qi Yang, Zhihui Tong
    Abstract:

    Background Patients could develop endocrine and exocrine Pancreatic Insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine Pancreatic Insufficiency after AP and the risk factors of endocrine Pancreatic Insufficiency through a long-term follow-up investigation.

Jenny Heathcote - One of the best experts on this subject based on the ideXlab platform.

Paolo Pederzoli - One of the best experts on this subject based on the ideXlab platform.

  • Pancreatic Insufficiency after different resections for benign tumours
    British Journal of Surgery, 2007
    Co-Authors: Massimo Falconi, William Mantovani, Stefano Crippa, Giuseppe Mascetta, Roberto Salvia, Paolo Pederzoli
    Abstract:

    Background: Pancreatic resections for benign diseases may lead to long-term endocrine/exocrine impairment. The aim of this study was to compare postoperative and long-term results after different Pancreatic resections for benign disease. Methods: Between 1990 and 1999, 62 patients underwent Pancreaticoduodenectomy (PD), 36 atypical resection (AR) and 64 left pancreatectomy (LP) for benign tumours. Exocrine and endocrine Pancreatic function was evaluated by 72-h faecal chymotrypsin and oral glucose tolerance test. Results: The incidence of Pancreatic fistula was significantly higher after AR than after LP (11 of 36 versus seven of 64; P = 0·028). The long-term incidence of endocrine Pancreatic Insufficiency was significantly lower after AR than after PD (P < 0·001). Exocrine Insufficiency was more common after PD (P < 0·001) and LP (P = 0·009) than after AR. The probability of developing both endocrine and exocrine Insufficiency was higher for PD and LP than for AR (32, 27 and 3 per cent respectively at 1 year; 58, 29 and 3 per cent at 5 years; P < 0·001). Conclusion: Different Pancreatic resections are associated with different risks of developing long-term Pancreatic Insufficiency. AR represents the best option in terms of long-term endocrine and exocrine function, although it is associated with more postoperative complications. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Guillermo Robles-díaz - One of the best experts on this subject based on the ideXlab platform.

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