| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3302580 | Gastrointestinal Endoscopy | 2015 | 7 Pages |
BackgroundDiagnosis of pancreatic exocrine insufficiency (PEI) is hindered by methodological difficulties of pancreatic function tests. The probability of PEI in chronic pancreatitis (CP) increases as pancreatic fibrosis develops. Pancreatic fibrosis in CP may be quantified by EUS elastography.ObjectiveTo evaluate whether EUS-elastography can predict PEI in patients with CP.DesignProspective, observational study.SettingDepartment of Gastroenterology, University Hospital of Santiago de Compostela, Spain.PatientsPatients diagnosed with CP based on EUS and magnetic resonance imaging and MRCP findings.InterventionsDiagnosis of PEI was based on the 13C-mixed triglyceride breath test. EUS-elastography was performed with PENTAX echoendoscopes and Hitachi-Preirus US platform. Two areas were selected for elastographic evaluation: area A corresponds to the pancreatic parenchyma and area B to a soft peripancreatic reference area. The quotient B/A (strain ratio [SR]) was considered the elastographic result.Main Outcome MeasurementsPancreatic SR in CP patients with and without PEI.ResultsA total of 115 patients with CP (mean age, 50.2 years, range, 21-81; 92 male) of different etiologies were included; 35 patients (30.4%) had PEI. Pancreatic SR was higher in patients with PEI (4.89; 95% confidence interval, 4.36-5.41) than in those with a normal breath test result (2.99; 95% confidence interval, 2.82-3.16) (P < .001). A direct relationship was found between the SR and the probability of PEI, which increases from 4.2% in patients with an SR less than 2.5 to 92.8% in those with an SR greater than >5.5.LimitationsSingle-center study.ConclusionsThe degree of pancreatic fibrosis as measured by EUS-guided elastography allows quantification of the probability of PEI in patients with CP.
