Pancreatic exocrine insufficiency after pancreatic resection: a systematic review
Abstract Introduction Pancreatic exocrine insufficiency (PEI) is a condition defined by a reduction in pancreatic exocrine activity that impairs normal digestion. Despite established guidelines recommendations, precise diagnosis of PEI after pancreatic resection are infrequently achieved. This revie...
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BMC
2025-02-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-025-02787-y |
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| author | Marcello Di Martino Ángela de la Hoz Rodriguez Andrea Saibanti Guillermo Salvador Camarmo Nico Pagano Elena Martín-Pérez Matteo Donadon |
| author_facet | Marcello Di Martino Ángela de la Hoz Rodriguez Andrea Saibanti Guillermo Salvador Camarmo Nico Pagano Elena Martín-Pérez Matteo Donadon |
| author_sort | Marcello Di Martino |
| collection | DOAJ |
| description | Abstract Introduction Pancreatic exocrine insufficiency (PEI) is a condition defined by a reduction in pancreatic exocrine activity that impairs normal digestion. Despite established guidelines recommendations, precise diagnosis of PEI after pancreatic resection are infrequently achieved. This review aims to provide a comprehensive overview of the methodology and accuracy of diagnostic tools available for evaluating PEI after pancreatic resection. Methods A review of PEI diagnostic tests was conducted using a combined text and MeSH search strategy to identify relevant articles focused on post-pancreatectomy PEI diagnosis. Results The literature search yielded 4,874 records, and 30 studies were included in the analysis, with a total of 2,305 patients. The reported frequency of PEI across the included studies varied widely, though more than two-thirds of included papers reported an incidence of PEI above 65% in patients who underwent pancreatoduodenectomy or distal pancreatectomy. The faecal elastase-1 (FE-1) test was the most frequently used test for diagnosing post-pancreatectomy PEI. Six studies compared the diagnostic accuracy of FE-1 with faecal fat tests or 13 C breath tests, finding no significant differences. Five studies reported on micronutrient deficiencies. Conclusion The FE-1 test is the most commonly used diagnostic tool for post-pancreatectomy PEI; however, well-designed studies comparing the diagnostic accuracy of various tests for PEI are lacking. Additionally, few studies report on micronutrient deficiencies, variations in anthropometric data or PEI-related patient-reported outcomes. Future studies should aim to establish a gold standard for diagnosis and severity assessment of post-pancreatectomy PEI and provide guidance for tailored pancreatic enzyme replacement therapy. |
| format | Article |
| id | doaj-art-14384afdd66442d2a0642298ee7f1af7 |
| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj-art-14384afdd66442d2a0642298ee7f1af72025-02-09T12:09:06ZengBMCBMC Surgery1471-24822025-02-0125111010.1186/s12893-025-02787-yPancreatic exocrine insufficiency after pancreatic resection: a systematic reviewMarcello Di Martino0Ángela de la Hoz Rodriguez1Andrea Saibanti2Guillermo Salvador Camarmo3Nico Pagano4Elena Martín-Pérez5Matteo Donadon6Department of Health Sciences, University of Piemonte OrientaleDepartment of Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM)Department of Health Sciences, University of Piemonte OrientaleDepartment of Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM)Division of Gastroenterology, University Maggiore Hospital della CaritàDepartment of Surgery, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM)Department of Health Sciences, University of Piemonte OrientaleAbstract Introduction Pancreatic exocrine insufficiency (PEI) is a condition defined by a reduction in pancreatic exocrine activity that impairs normal digestion. Despite established guidelines recommendations, precise diagnosis of PEI after pancreatic resection are infrequently achieved. This review aims to provide a comprehensive overview of the methodology and accuracy of diagnostic tools available for evaluating PEI after pancreatic resection. Methods A review of PEI diagnostic tests was conducted using a combined text and MeSH search strategy to identify relevant articles focused on post-pancreatectomy PEI diagnosis. Results The literature search yielded 4,874 records, and 30 studies were included in the analysis, with a total of 2,305 patients. The reported frequency of PEI across the included studies varied widely, though more than two-thirds of included papers reported an incidence of PEI above 65% in patients who underwent pancreatoduodenectomy or distal pancreatectomy. The faecal elastase-1 (FE-1) test was the most frequently used test for diagnosing post-pancreatectomy PEI. Six studies compared the diagnostic accuracy of FE-1 with faecal fat tests or 13 C breath tests, finding no significant differences. Five studies reported on micronutrient deficiencies. Conclusion The FE-1 test is the most commonly used diagnostic tool for post-pancreatectomy PEI; however, well-designed studies comparing the diagnostic accuracy of various tests for PEI are lacking. Additionally, few studies report on micronutrient deficiencies, variations in anthropometric data or PEI-related patient-reported outcomes. Future studies should aim to establish a gold standard for diagnosis and severity assessment of post-pancreatectomy PEI and provide guidance for tailored pancreatic enzyme replacement therapy.https://doi.org/10.1186/s12893-025-02787-yPancreatectomyPancreatoduodenectomyDistal pancreatectomyPancreatic enzymePancreatic insufficiencyPancreatic replacement therapy |
| spellingShingle | Marcello Di Martino Ángela de la Hoz Rodriguez Andrea Saibanti Guillermo Salvador Camarmo Nico Pagano Elena Martín-Pérez Matteo Donadon Pancreatic exocrine insufficiency after pancreatic resection: a systematic review BMC Surgery Pancreatectomy Pancreatoduodenectomy Distal pancreatectomy Pancreatic enzyme Pancreatic insufficiency Pancreatic replacement therapy |
| title | Pancreatic exocrine insufficiency after pancreatic resection: a systematic review |
| title_full | Pancreatic exocrine insufficiency after pancreatic resection: a systematic review |
| title_fullStr | Pancreatic exocrine insufficiency after pancreatic resection: a systematic review |
| title_full_unstemmed | Pancreatic exocrine insufficiency after pancreatic resection: a systematic review |
| title_short | Pancreatic exocrine insufficiency after pancreatic resection: a systematic review |
| title_sort | pancreatic exocrine insufficiency after pancreatic resection a systematic review |
| topic | Pancreatectomy Pancreatoduodenectomy Distal pancreatectomy Pancreatic enzyme Pancreatic insufficiency Pancreatic replacement therapy |
| url | https://doi.org/10.1186/s12893-025-02787-y |
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