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pancreatic exocrine insufficiency

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https://www.readbyqxmd.com/read/28912804/assessment-of-nutritional-status-digestion-and-absorption-and-quality-of-life-in-patients-with-locally-advanced-pancreatic-cancer
#1
J E Witvliet-van Nierop, C M Lochtenberg-Potjes, N J Wierdsma, H J Scheffer, G Kazemier, K Ottens-Oussoren, M R Meijerink, M A E de van der Schueren
BACKGROUND AND AIM: To provide a comprehensive quantitative assessment of nutritional status, digestion and absorption, and quality of life (QoL) in patients with locally advanced pancreatic cancer (LAPC). METHODS: Sixteen patients with LAPC were prospectively assessed for weight loss (WL), body mass index (BMI), fat-free mass index (FFMI), handgrip strength (HGS), dietary macronutrient intake, serum vitamin levels, resting and total energy expenditure (REE and TEE, indirect calorimetry), intestinal absorption capacity and fecal losses (bomb calorimetry), exocrine pancreatic function (fecal elastase-1 (FE1)), and gastrointestinal quality of life (GIQLI)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28912050/pancreatic-enzyme-replacement-therapy-in-children-with-severe-acute-malnutrition-a-randomized-controlled-trial
#2
Rosalie H Bartels, Céline Bourdon, Isabel Potani, Brian Mhango, Deborah A van den Brink, John S Mponda, Anneke C Muller Kobold, Robert H Bandsma, Michael Boele van Hensbroek, Wieger P Voskuijl
OBJECTIVE: To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. STUDY DESIGN: We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central Hospital in Malawi. All children received standard care; the intervention group also received PERT for 28 days. RESULTS: Children treated with PERT for 28 days did not gain more weight than controls (13...
September 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28902786/diagnosing-chronic-pancreatitis-comparison-and-evaluation-of-different-diagnostic-tools
#3
Yama Issa, Hjalmar C van Santvoort, Susan van Dieren, Marc G Besselink, Marja A Boermeester, Usama Ahmed Ali
OBJECTIVES: This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP). METHODS: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28894791/pancreas-transplantation-with-portal-enteric-drainage-for-patients-with-endocrine-and-exocrine-insufficiency-from-extensive-pancreatic-resection
#4
Andrew S Barbas, David P Al-Adra, Nicolas Goldaracena, Martin J Dib, Markus Selzner, Gonzalo Sapisochin, Mark S Cattral, Ian D McGilvray
Although the primary indication for pancreas transplantation is type I diabetes, a small number of patients requires pancreas transplantation to manage combined endocrine and exocrine insufficiency that develops after extensive native pancreatic resection. The objective of this case report was to describe the operative and clinical course in 3 such patients and present an alternative technical approach.
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28886391/combined-pancreatic-and-duodenal-transection-injury-a-case-report
#5
Simbarashe Gift Mungazi, Chenesa Mbanje, Onesai Chihaka, Noah Madziva
INTRODUCTION: Combined pancreatic-duodenal injuries in blunt abdominal trauma are rare. These injuries are associated with high morbidity and mortality, and their emergent management is a challenge. CASE PRESENTATION: We report a case of combined complete pancreatic (through the neck) and duodenal (first part) transections in a 24-year-old male secondary to blunt abdominal trauma following a motor vehicle crash. The duodenal stumps were closed separately and a gastrojejunostomy performed for intestinal continuity...
August 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28880010/chronic-pancreatitis
#6
REVIEW
Jorg Kleeff, David C Whitcomb, Tooru Shimosegawa, Irene Esposito, Markus M Lerch, Thomas Gress, Julia Mayerle, Asbjørn Mohr Drewes, Vinciane Rebours, Fatih Akisik, J Enrique Domínguez Muñoz, John P Neoptolemos
Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. The pathophysiology of chronic pancreatitis is fairly complex and includes acinar cell injury, acinar stress responses, duct dysfunction, persistent or altered inflammation, and/or neuro-immune crosstalk, but these mechanisms are not completely understood...
September 7, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28861620/nationwide-survey-of-hereditary-pancreatitis-in-japan
#7
Atsushi Masamune, Kazuhiro Kikuta, Shin Hamada, Eriko Nakano, Kiyoshi Kume, Ayano Inui, Toshiaki Shimizu, Yoshifumi Takeyama, Masaki Nio, Tooru Shimosegawa
BACKGROUND: Hereditary pancreatitis (HP) is a rare cause of chronic pancreatitis. We here report a nationwide survey to clarify the epidemiological, genetic, and clinical features of HP in Japan. METHODS: Target subjects were patients with HP and their family members who had visited selected hospitals between 2005 and 2014. This study consisted of two-stage surveys; patients with HP were identified by the first questionnaire and their clinical features were assessed by the second questionnaire...
August 31, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28858943/increased-risk-of-mortality-associated-with-pancreatic-exocrine-insufficiency-in-patients-with-chronic-pancreatitis
#8
Daniel de la Iglesia-Garcia, Nicolau Vallejo-Senra, Julio Iglesias-Garcia, Andrea López-López, Laura Nieto, J Enrique Domínguez-Muñoz
BACKGROUND: Pancreatic exocrine insufficiency (PEI) is a common serious complication in chronic pancreatitis (CP); however, little is known about its effect on mortality in these patients. In this study, we assessed the mortality risk of PEI in patients with CP. STUDY: A prospective, longitudinal cohort study conducted in patients with CP under long-term follow-up. CP and PEI were diagnosed using pancreatic imaging and the C-labeled mixed triglyceride breath test, respectively...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28838283/exocrine-pancreatic-insufficiency-is-common-in-people-living-with-hiv-on-effective-antiretroviral-therapy
#9
Aylin Yilmaz, Lars Hagberg
OBJECTIVES: The primary aim of this prospective study was to determine the prevalence of exocrine pancreatic insufficiency (EPI) in people living with HIV (PLHIV) on suppressive antiretroviral therapy (ART). METHODS: PLHIV ≥18 years of age and on ART for >6 months and with HIV RNA <50 copies/mL plasma were included. Faecal elastase-1 measurement was performed on a single stool sample, serum markers of malnutrition were collected, and participants answered a short questionnaire about gastrointestinal symptoms...
August 25, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28834847/new-onset-of-diabetes-and-pancreatic-exocrine-insufficiency-after-pancreaticoduodenectomy-for-benign-and-malignant-tumors-a-systematic-review-and-meta-analysis-of-long-term-results
#10
Hans G Beger, Bertram Poch, Benjamin Mayer, Marco Siech
OBJECTIVE: The aim of this study was to assess the frequency and severity of new onset of diabetes mellitus (NODM) and pancreatic exocrine insufficiency (PEI) after pancreaticoduodenectomy (PD) for benign and malignant tumors. SUMMARY BACKGROUND DATA: When PD is performed on patients for benign tumors, the question of long-term metabolic dysfunctions becomes of importance. METHODS: Medline/PubMed, Embase, and Cochrane Library were searched for articles reporting results of measuring endocrine and exocrine pancreatic functions after PD...
August 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28821361/major-postoperative-complications-after-pancreatic-resection-for-p-nets-are-not-associated-to-earlier-recurrence
#11
R Valente, P Lykoudis, D Tamburrino, M Inama, I Passas, C Toumpanakis, T V Luong, B Davidson, C Imber, M Malagò, S H Rahman, A Shankar, D Sharma, M Caplin, G Fusai
BACKGROUND: The oncological impact of surgical complications has been studied in visceral and pancreatic cancer. AIM: To investigate the impact of complications on tumour recurrence after resections for pancreatic neuroendocrine tumours. METHODS: We have retrospectively analysed 105 consecutive resections performed at the Royal Free London Hospital from 1998 to 2014, and studied the long-term outcome of nil-minor (<3) versus major (≥3) Clavien-Dindo complications (CD) on disease-free (DFS) and overall survival (OS)...
August 2, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#12
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28809096/pancreatico-jejunostomy-decreases-post-operative-pancreatic-fistula-incidence-and-severity-after-central-pancreatectomy
#13
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28804801/pancreatic-enzyme-supplementation-after-gastrectomy-for-gastric-cancer-a-randomized-controlled-trial
#14
Marco Catarci, Manuele Berlanda, Giovanni Battista Grassi, Francesco Masedu, Stefano Guadagni
BACKGROUND: Gastrectomy for gastric cancer is a significant cause of secondary exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy may influence nutritional status and quality of life after gastrectomy, but the pertinent clinical research to date remains controversial. A randomized controlled trial to test this hypothesis was carried out. METHODS: After gastrectomy, 43 patients with gastric cancer were randomly assigned to a normal diet (Normal-d; n = 21) or to a pancreatic enzyme supplementation diet (PES-d; n = 22) and were followed up during a 12-month period, assessing nutritional status and quality of life through body mass index (BMI), instant nutritional assessment (INA) class status, serum pre-albumin (SPA) values, and GastroiIntestinal Quality of Life Index (GIQLI)...
August 14, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28782667/features-of-autoimmune-pancreatitis-associated-with-inflammatory-bowel-diseases
#15
Diane Lorenzo, Frédérique Maire, Carmen Stefanescu, Jean-Marc Gornet, Philippe Seksik, Mélanie Serrero, Barbara Bournet, Philippe Marteau, Aurelien Amiot, David Laharie, Caroline Trang, Benoit Coffin, Guy Bellaiche, Guillaume Cadiot, Catherine Reenaers, Antoine Racine, Stephanie Viennot, Arnaud Pauwels, Guillaume Bouguen, Guillaume Savoye, Anne-Laure Pelletier, Guillaume Pineton de Chambrun, Pierre Lahmek, Stéphane Nahon, Vered Abitbol
BACKGROUND & AIMS: Few people know of autoimmune pancreatitis (AIP), a rare disorder associated with inflammatory bowel diseases (IBD). We aimed to describe phenotype and outcomes of AIP in patients with AIP. METHODS: We performed a retrospective study of cases of AIP in IBD identified from the multi-center Groupe d'Etude Thérapeutique des Affections Inflammatoires du tube Digestif study, performed in Belgium and France from July 2012 through July 2015. Patients were diagnosed with AIP based on histological analysis of pancreatic resection specimens or samples collected by fine-need aspiration during endoscopic ultrasound...
August 3, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28768898/morphological-and-functional-consequences-and-quality-of-life-following-severe-acute-pancreatitis
#16
Dorota Koziel, Edyta Suliga, Urszula Grabowska, Stanislaw Gluszek
In this study, we evaluated pancreatic morphology and function as well as nutritional status and quality of life among patients who experienced severe acute pancreatitis (SAP). MATERIALS AND METHODS: We enrolled 99 patients with SAP and 51 with mild acute pancreatitis (MAP). Computed tomography was performed one year following the disease. Endocrine function was evaluated by measuring hemoglobin A1c, insulin, and C peptide levels. Pancreatic exocrine insufficiency (PEI) was diagnosed by the concentration of fecal elastase-1...
June 23, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28741615/patient-and-disease-characteristics-associated-with-the-presence-of-diabetes-mellitus-in-adults-with-chronic-pancreatitis-in-the-united-states
#17
Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28739210/bile-salt-stimulated-lipase-inhibition-by-phospholipids-and-relief-by-phospholipase-a2
#18
Elena Venuti, Dmitry Shishmarev, Philip W Kuchel, Shoma Dutt, Caron S Blumenthal, Kevin J Gaskin
INTRODUCTION: Bile salt stimulated lipase (BSSL; Enzyme Commission (EC) number 3.1.1.13) has been a candidate triglyceridase for improving enzyme therapy for pancreatic insufficiency; however, its efficacy is near absent. We hypothesise that similarly to pancreatic lipase, BSSL is inhibited by phospholipids and this inhibition is relieved by Phospholipase A2 (PLA2; EC 3.1.1.4), and the present study was undertaken to explore this possibility. MATERIALS AND METHODS: Synthetic emulsions of triglyceride and phosphatidylcholine (PC) or lysophosphatidylcholine (LPC)/bile salt mixed micelles were used as a model of intestinal digestion-media...
July 21, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28735575/negotiating-the-complexities-of-exocrine-and-endocrine-dysfunction-in-chronic-pancreatitis
#19
Sinead N Duggan
Chronic pancreatitis is a chronic inflammatory disease of the pancreas characterised by irreversible morphological change and typically causing pain and/or permanent loss of function. This progressive, irreversible disease results in destruction of healthy pancreatic tissue and the development of fibrous scar tissue. Gradual loss of exocrine and endocrine function follows, along with clinical manifestations such as steatorrhoea, abdominal pain and diabetes. Nutrition in chronic pancreatitis has been described as a problem area and, until recently, there was little research on the topic...
July 24, 2017: Proceedings of the Nutrition Society
https://www.readbyqxmd.com/read/28727476/options-for-addressing-exocrine-pancreatic-insufficiency-in-patients-receiving-enteral-nutrition-supplementation
#20
Steven D Freedman
Patients with exocrine pancreatic insufficiency (EPI) have suboptimal secretion of pancreatic digestive enzymes and experience a range of clinical symptoms related to the malabsorption of fat. In patients with EPI unable to meet their nutritional requirements, enteral nutrition (EN) support is used to augment nutritional status. In addition to protein and carbohydrate, EN formulas contain fats as a calorie source, as well as vitamins and minerals to help prevent nutritional deficiencies related to malabsorption...
July 2017: American Journal of Managed Care
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