title: Exocrine pancreatic function in biliary tract pathology treated with the endoscopic methods.
abstract: OBJECTIVE
  Incidence of pancreatic exocrine insufficiency in biliary pathology is estimated for about 30%. The objective was to assess pancreatic exocrine function in biliary tract pathology (cholelithiasis, strictures) before and after endoscopic treatment.
  
  
  METHODS
  Twenty-eight patients with choledocholithiasis and its complications (19F/9M; aging 31-90 years, median: 69 years) were evaluated. Fecal elastase 1 concentration was measured using ELISA, before, early, and 6-8 weeks after endoscopic treatment. The inflammatory response of pancreas to the treatment was also assessed.
  
  
  RESULTS
  Initial fecal elastase 1 concentration in patients (median 454 microg/g) was not significantly different as compared to the control (median 357 microg/g). Nine patients (32%) had low fecal elastase 1 concentration (below 250 microg/g) and out of them 6 had the concentration below 200 microg/g, suggesting impairment of exocrine pancreatic function. Endoscopic treatment was successful in 82% of patients. Pancreatic inflammatory response was noted only in one patient. After 6-8 weeks fecal elastase 1 concentration in the whole group of patients did not significantly change in comparison to the initial level. However, out of 9 patients with initially low fecal elastase 1 concentration (median 191 microg/g) at least in 6 pancreatic function improved (median 310 microg/g), P < 0.001.
  
  
  CONCLUSIONS
  One third of the patients with biliary pathology had a low fecal elastase 1 concentrations, suggesting pancreatic dysfunction. In at least 2/3 of these patients successful endoscopic treatment of biliary pathology resulted in the significant increase of fecal elastase 1 concentration. Therefore, an additional positive effect of such treatment in some patients, could be an improvement of the exocrine pancreatic dysfunction.
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Białystok, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Wasielica-Berger
authors.forename: J W
authors.initials: JW
authors.lastname: Długosz
authors.forename: W
authors.initials: W
authors.lastname: Łaszewicz
authors.forename: A
authors.initials: A
authors.lastname: Baniukiewicz
authors.forename: I
authors.initials: I
authors.lastname: Werpachowska
authors.forename: B
authors.initials: B
authors.lastname: Mroczko
authors.forename: A
authors.initials: A
authors.lastname: Dabrowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001652:Bile Ducts / Q000473:pathology; D001659:Biliary Tract / Q000473:pathology*; D001663:Bilirubin / Q000378:metabolism; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D020347:Lithiasis; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000502:physiology*; D010196:Pancreatic Elastase / Q000097:blood / Q000378:metabolism; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D000516:alpha-Amylases; D010196:Pancreatic Elastase; D001663:Bilirubin