Comparison of endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, and fecal elastase 1 in chronic pancreatitis and clinical correlation.
OBJECTIVE
In this study, we prospectively compared the use of endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), and fecal elastase 1 in patients with chronic pancreatitis and searched for correlation with symptoms, clinical findings, and elastase 1 levels.


METHODS
Twenty-four consecutive patients (19 were male, and 5 were female) with chronic pancreatitis who had already undergone ERCP within the last 2 years and 19 healthy control subjects (10 were male, and 9 were female) are studied prospectively. Clinical and laboratory parameters of the patients were recorded, and all underwent EUS and fecal elastase 1 testing. Fecal elastase 1 was measured in healthy control subjects.


RESULTS
The ERCP and EUS severity scores were 1 in 0 to 2 patients, 2 in 6 to 8 patients, and 3 in 18 to 14 patients. Sensitivity and specificity of fecal elastase for chronic pancreatitis were 75% and 100%, respectively. There was a negative correlation between disease duration and fecal elastase 1 levels. Patients with dyspepsia or those who use pancreatic enzyme preparations had significantly lower fecal elastase 1 levels than others.


CONCLUSIONS
Endoscopic retrograde cholangiopancreatography and EUS are nearly equal in staging chronic pancreatitis. Fecal elastase 1 correlates well with these tests. Fecal elastase 1 also correlates well with some clinical symptoms such as dyspepsia and disease history.
Usküdar
Oğuz
O
Department of Gastroenterology, Ankara Diskapi Education and Research Hospital, Ankara, Turkey. ouskudar@hotmail.com
Oğuz
Dilek
D
Akdoğan
Meral
M
Altiparmak
Emin
E
Sahin
Burhan
B
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004415:Dyspepsia / Q000175:diagnosis / Q000201:enzymology; D019160:Endosonography; D005243:Feces / Q000201:enzymology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology / Q000473:pathology; D010196:Pancreatic Elastase / Q000378:metabolism*; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000201:enzymology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D010196:Pancreatic Elastase