From the Research
Frequency of Checking Fecal Elastase (FE) after Necrotizing Pancreatitis
- The frequency of checking fecal elastase (FE) after necrotizing pancreatitis for pancreatic exocrine insufficiency (PEI) is not explicitly stated in the provided studies.
- However, study 1 suggests that the prevalence of PEI may change over time, and patients with necrotizing pancreatitis may require long-term follow-up to monitor their pancreatic function.
- Study 2 recommends that patients with severe acute pancreatitis (SAP) and necrotizing acute pancreatitis (NAP) should be followed for pancreatic functions, including exocrine dysfunction, which can be evaluated using fecal pancreatic elastase-I (FPE-I) tests.
- Study 3 prospectively evaluated patients with walled-off necrosis (WON) at baseline, 3-6 months after discharge, and 12 months after discharge, using fecal elastase tests to assess exocrine insufficiency.
Factors Influencing the Frequency of FE Checks
- Disease severity and necrosis ratio may influence the frequency of FE checks, as patients with SAP and NAP may require more frequent monitoring of their pancreatic function 2.
- The presence of pancreatic head necrosis or near-total necrosis may also affect the frequency of FE checks, as these patients may be at higher risk of developing exocrine dysfunction 2.
- The development of endocrine dysfunction may also influence the frequency of FE checks, as patients with both exocrine and endocrine insufficiency may require more comprehensive monitoring and treatment 3.
FE Test Results and Clinical Implications
- Study 4 found that patients with initial FE1 <15 μg/g were unlikely to be reclassified on repeat testing, suggesting that these patients may not require frequent FE checks.
- Study 5 found that fecal elastase-1 levels were clearly reduced in chronic pancreatitis, and that the sensitivity and specificity of fecal elastase-1 in detecting chronic pancreatitis were 0.64 and 0.95, respectively.
- Study 3 found that 12 months after discharge, 29% of patients with WON had mild exocrine insufficiency, 7% had moderate insufficiency, and 50% had severe insufficiency based on the Lundh's test, highlighting the importance of long-term follow-up and monitoring of pancreatic function in these patients.