title: [Pancreatic elastase-1 in the stool for the determination of exocrine pancreas function of postoperative patients with early enteral nutrition -- a pilot study].
abstract: OBJECTIVE
  There are only incomplete data about exocrine pancreatic function after major gastrointestinal surgery. Early enteral nutrition with high-molecular diets is increasingly administered to these patients. A knowledge of exocrine secretion of the pancreas is crucial, because pancreatic enzymes are needed for the adsorption of the high-molecular diets. To determine the exocrine pancreatic secretion the fecal elastase-1 is a sensitive method for measuring exocrine pancreatic secretion.
  
  
  METHODS
  In a prospective study fecal elastase-1 was measured in patients on enteral nutrition (n=12) early after major gastrointestinal operations. They were given a high molecular diet via an intraoperatively placed small-needle catheter jejunostomy, starting 12 hours after operation with a continuous infusion of 20 ml/h (1 kcal/ml),increased to 80 ml/h during the next few days. Samples from the first and second stools after beginning the enteral nutrition were taken for measuring the fecal elastase-1.
  
  
  RESULTS
  All patients fed enterally had no relevant feeding-associated complications and no diarrhea. The elastase-1 concentrations were normal in both the first and the second stool samples in all patients (normal stool elastase is > 200 g/g). The average elastase concentration in the first stool sample was 361,4 mg/g (median: 317 mg/g) and 454 mg/g in the second (median: 466,6 mg/g). Thus no exocrine pancreatic insufficiency was detected in any of the patients.
  
  
  CONCLUSIONS
  The results of elastase-1 in stool demonstrate that severe exocrine pancreas dysfunction is not generally present in patients on early enteral nutrition after major gastrointestinal surgery.
authors.affiliation: Chirurgische Klinik der Ruhr-Universität Bochum, St. Josef Hospital. Senkal@Marien-Hospital-Witten.de
authors.forename: M
authors.initials: M
authors.lastname: Senkal
authors.forename: B
authors.initials: B
authors.lastname: Marpe
authors.forename: T
authors.initials: T
authors.lastname: Deska
authors.forename: V
authors.initials: V
authors.lastname: Zumtobel
authors.forename: M
authors.initials: M
authors.lastname: Adolph
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000379:methods*; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000201:enzymology; D005243:Feces / Q000201:enzymology*; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000502:physiology*; D010196:Pancreatic Elastase / Q000032:analysis*; D010865:Pilot Projects; D011182:Postoperative Care; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D010196:Pancreatic Elastase