Exocrine pancreatic function during the early recovery phase of acute pancreatitis.
BACKGROUND
Exocrine pancreatic dysfunction has been reported in humans in the convalescent period after acute pancreatitis, but the data are scarce and conflicting. This study aimed to prospectively assess the exocrine pancreatic function in patients with acute pancreatitis at the time of their refeeding.


METHODS
Fecal elastase-1 was determined on the day of refeeding in all consecutive acute pancreatitis patients with their first episode of the disease. They were 75 patients including 60 (80.0%) patients with mild acute pancreatitis and 15 (20.0%) patients with severe acute pancreatitis. Etiologically 61 patients (81.3%) had biliary disease, 1 (1.3%) had alcoholic disease and 3 (4.0%) had hypertriglyceridemia. No causes of acute pancreatitis were found in the remaining 10 patients (13.3%). The mean (+/-SD) refeeding time after the attack of acute pancreatitis was 11.2+/-10.2 days.


RESULTS
Pathological values of fecal elastase-1 were found in 9 of the 75 patients (12.0%): 7 (9.3%) patients with mild pancreatitis and 2 (2.7%) patients with severe pancreatitis (P=1.000). The frequency of the pathological values of fecal elastase-1 was significantly different from that of various etiologies of the disease (P=0.030). It was significantly lower in patients with biliary pancreatitis (9.8%; P=0.035) than in one patient with alcoholic pancreatitis (P=0.126), one patient with hypertriglyceridemia-induced pancreatitis (33.3%; P=0.708), and one patient with idiopathic pancreatitis (10.0%; P=0.227). Pathological fecal elastase-1 was not significantly related to sex, age or day of refeeding.


CONCLUSIONS
Exocrine pancreatic function should be routinely assessed in patients with acute pancreatitis at the time of refeeding in order to supplement their diet with pancreatic extracts.
Pezzilli
Raffaele
R
Department of Digestive Diseases and Internal Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. raffaele.pezzilli@aosp.bo.it.
Simoni
Patrizia
P
Casadei
Riccardo
R
Morselli-Labate
Antonio M
AM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000150:complications; D005243:Feces / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D005502:Food; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000503:physiopathology*; D010196:Pancreatic Elastase / Q000032:analysis; D010195:Pancreatitis / Q000201:enzymology / Q000209:etiology / Q000503:physiopathology*; D019512:Pancreatitis, Alcoholic / Q000201:enzymology; D011446:Prospective Studies; D020127:Recovery of Function; D055815:Young Adult
D010196:Pancreatic Elastase