Title: Comparative evaluation of three indirect pancreatic function tests in patients with chronić pancreatitis before and after the operation
- Dorota Diakowska, Witold Knast, Piotr Szelachowski
- Original articles
- Polish Gastroenterology
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- Final page:
- chronic pancreatitis, pancreatic function tests, fecal fat, fecal elastase 1
Introduction: The estimation of severe exocrine pancreatic insufficiency is very useful in recognising and mo-nitoring the results of chronić pancreatitis treatment as well as operation treatment. Aim: The aim of the presented study was a comparative evaluation of three indirect pancreatic function tests: the amount of undigested lipids in stool per day, fecal fat concentration and fecal elastase 1 concen-tration in stool of patients with chronić pancreatitis before and after the operation.
Material and methods: In the years 2000-2001 27 patients with chronić pancreatitis (chp) were treated at the Departament of Gastrointestinal Surgery of Medical University in Wrocław. Patients underwent operations and then pharmacological treatment. 15 patients with ventral hernia were studied as normal controls. In all patients the following pancreatic function tests were conducted: the amount of undigested lipids in stool per day, fecal fat concentration and fecal elastase 1 concentration. Body mass index was used in the compa-rison of the body mass changes in patients with chp. Results: Before the operations the majority of patients showed weight loss (BMI=18.3±2.75). The fecal fat excretion per day was very high (22.04±12.83 g/day), fecal fat concentration was high (9.61 ±4.23 g%) and fecal elastase 1 concentration was Iow (46.3±23 ug E/g stool).
After the operations patients showed health improvement: fecal fat excretion was 11.82±7.28 g/day, fecal fat concentration was 6.02±3.25 g% and fecal elastase 1 concentration was 73.3±80.8 ug E/g stool. After the operations in patients pharmacological therapy was applied and the tests showed: body weight growth (BMI=21.8±3.6), normalization of fecal fat excretion (6.82±2.7 g/day), fecal fat concentration was 4.39±2.31 g, and fecal elastase 1 concentration was 100±93,4 ug E/g stool.
Fecal elastase 1 determination with a cut of >100 ug E/g stool was sensitive in 89% for the detection of se-vere exocrine pancreatic insufficiency, fecal fat concentration was sensitive in 93% for severe exocrine pancreatic insufficiency. Fecal fat excretion per day shows excellent 100% sensitivity for severe exocrine pancreatic insufficiency.