Evidence map›Paper›PMID 31161524›Full record

SynthesisDigestive diseases and sciences2019

Exocrine Pancreatic Insufficiency Following Acute Pancreatitis: Systematic Review and Meta-Analysis.

Wei Huang, Daniel de la Iglesia-García, Iria Baston-Rey, Cristina Calviño-Suarez, Jose Lariño-Noia, Julio Iglesias-Garcia, Na Shi, Xiaoying Zhang, Wenhao Cai, Lihui Deng and 6 more

3 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 62 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 4 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05480241 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Impact of Exocrine Pancreatic Insufficiency Associated With Acute Pancreatitis and Pancreatic Enzyme Replacement Therapy on Gut Microbiota, Immunological Changes and Quality of Life

TypeinterventionalSponsorUnidade Local de Saúde de Coimbra, EPERan2022 to 2024Enrolled84ConditionsAcute Pancreatitis, Exocrine Pancreatic Insufficiency, Gut Microbiota, ImmunologyArmsPancreatic Enzyme Replacement Therapy, Placebo
NCT07211568 phase3not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Pancreatic Enzyme Replacement Therapy on Nutrition in Acute Pancreatitis: A Multicenter Double Blinded Randomised Placebo Controlled Trial.

TypeinterventionalSponsorAsian Institute of Gastroenterology, IndiaRan2025 to 2027Enrolled188ConditionsAcute Pancreatitis Necrotizing, Nutrition AssessmentArmsPancreatic Enzyme Replacement Therapy, Placebo
NCT07441824 phase3recruitingnot on this mapstarted 2026, after this paper: background citation

Effect of Pancreatic Enzyme Replacement Therapy in Patients With Acute Necrotizing Pancreatitis: A Multicenter Double Blinded Randomised Placebo Controlled Trial

TypeinterventionalSponsorAsian Institute of Gastroenterology, IndiaRan2026 to 2027Enrolled140ConditionsAcute Necrotizing Pancreatitis, Pancreatic Exocrine InsufficiencyArmsPancreatic enzyme capsules, Placebo
3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Article
  6. Review
  7. Observational
  8. Pancreatic enzyme replacement therapy for exocrine pancreatic insufficiency-Insights into prescribing practices.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Article
  9. Article
  10. Pancreatic exocrine insufficiency beyond pancreatitis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Review
  11. Review
  12. Review
  13. Review
  14. Clinical Practice Update on the Evaluation, Diagnosis, and Management of Pancreatic Exocrine Insufficiency: Expert Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026
    Review
  15. Pancreatic exocrine insufficiency.EClinicalMedicine · 2026
    Review
  16. Article
  17. Review
  18. Article
  19. Review
  20. Article

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 5 countries.

Wei HuangDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
Daniel de la Iglesia-GarcíaDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Iria Baston-ReyDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Cristina Calviño-SuarezDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Jose Lariño-NoiaDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Julio Iglesias-GarciaDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Na ShiDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
Xiaoying ZhangDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
Wenhao CaiDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
Lihui DengDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
Danielle MooreLiverpool Pancreatitis Research Group, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Vikesh K SinghPancreatitis Center, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, USA.
Qing XiaDepartment of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
John A WindsorSurgical and Translational Research Center, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
J Enrique Domínguez-MuñozDepartment of Gastroenterology and Hepatology, Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. enriquedominguezmunoz@hotmail.com.
Robert SuttonLiverpool Pancreatitis Research Group, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. r.sutton@liverpool.ac.uk.
Instituto de Investigación Sanitaria de Santiago · ESSichuan University · CNUniversity of Liverpool · GBJohns Hopkins University · USRoyal Liverpool University Hospital · GBUniversity of Auckland · NZ

Funding

Department of Health EME/15/20/01
6 · The paper itself

Abstract

BACKGROUND/

objectivesThe epidemiology of exocrine pancreatic insufficiency (EPI) after acute pancreatitis (AP) is uncertain. We sought to determine the prevalence, progression, etiology and pancreatic enzyme replacement therapy (PERT) requirements for EPI during follow-up of AP by systematic review and meta-analysis.

methodsScopus, Medline and Embase were searched for prospective observational studies or randomized clinical trials (RCTs) of PERT reporting EPI during the first admission (between the start of oral refeeding and before discharge) or follow-up (≥ 1 month of discharge) for AP in adults. EPI was diagnosed by direct and/or indirect laboratory exocrine pancreatic function tests.

resultsQuantitative data were analyzed from 370 patients studied during admission (10 studies) and 1795 patients during follow-up (39 studies). The pooled prevalence of EPI during admission was 62% (95% confidence interval: 39-82%), decreasing significantly during follow-up to 35% (27-43%; risk difference: - 0.34, - 0.53 to - 0.14). There was a two-fold increase in the prevalence of EPI with severe compared with mild AP, and it was higher in patients with pancreatic necrosis and those with an alcohol etiology. The prevalence decreased during recovery, but persisted in a third of patients. There was no statistically significant difference between EPI and new-onset pre-diabetes/diabetes (risk difference: 0.8, 0.7-1.1, P = 0.33) in studies reporting both. Sensitivity analysis showed fecal elastase-1 assay detected significantly fewer patients with EPI than other tests.

conclusionsThe prevalence of EPI during admission and follow-up is substantial in patients with a first attack of AP. Unanswered questions remain about the way this is managed, and further RCTs are indicated.

Indexed as

AdultAgedAged, 80 and overEnzyme Replacement TherapyExocrine Pancreatic InsufficiencyFemaleHumansMaleMiddle AgedObservational Studies as TopicPancreatitisPrevalenceRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeAcute pancreatitisExocrine pancreatic insufficiencyNecrotizing pancreatitisPancreatic enzyme replacement therapySevere pancreatitis

Identifiers

PMID31161524
PMCPMC6584228
OpenAlexW2948505953

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.