ArticleAmerican journal of translational research2025
Incidence of pancreatic exocrine insufficiency and efficacy of pancreatic enzyme replacement therapy in acute pancreatitis patients.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate the incidence and risk factors of pancreatic exocrine insufficiency (PEI) in patients with acute pancreatitis (AP) and to assess the clinical efficacy of pancreatic enzyme replacement therapy (PERT).
methodsA retrospective study was conducted with 371 patients with AP. Patients were classified into mild acute pancreatitis (MAP, n=88), moderately severe acute pancreatitis (MSAP, n=192), and severe acute pancreatitis (SAP, n=91). Risk factors for PEI were identified through logistic regression analysis. The therapeutic efficacy was assessed by comparing the group receiving PERT with the control group (n=72) receiving conventional treatment. Patients were assigned to the treatment and control groups based on the severity of their condition (mainly MSAP and SAP, n=55) and whether they met the diagnostic criteria for PEI (based on FE-1 levels).
resultsThe incidence of PEI was 39.9%. A higher proportion of patients with PEI had SAP (37.2%) and infected pancreatic necrosis (P<0.001). Compared to the control group, the Treatment Group demonstrated significantly lower rates of enteral nutrition intolerance, higher 24-hour relief rates, and improved bowel function on day 7 (all P<0.05). Subgroup analyses revealed that PERT significantly improved intolerance and bowel function in MSAP patients and reduced intolerance in SAP patients. Hospital stay was shorter in the Treatment Group (P=0.012), especially in MSAP patients (P=0.001), while no significant difference was observed in SAP patients (P=0.880). Treatment costs were similar between the groups.
conclusionsPEI is prevalent in AP, particularly in severe cases. PERT effectively alleviates enteral nutrition intolerance, enhances bowel function, and shortens hospital stays, especially in MSAP patients. The development of PEI is strongly associated with disease severity and infected necrosis, highlighting the clinical value of PERT.
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