Prevalence of Radiological Chronic Pancreatitis and Exocrine Pancreatic Insufficiency in Patients with Decompensated Liver Disease: Is Fecal Elastase Useful in This Setting?

Gemma Llibre Nieto ^{1, 2, 3}

Alba Lira ¹

Mercedes Vergara ^{1, 2, 4}

Meritxell Casas ¹

Cristina Solé ^{1, 4}

José Ferrusquía-Acosta ^{1, 4}

Valentí Puig-Diví ⁵

Laia Grau López ⁶

Josep Maria Barradas ⁷

Marta Solà ⁸

Mireia Miquel ^{1, 2, 4, 9}

Jordi Sanchez Delgado ^{1, 2, 4}

Show full list: 12 authors

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Unitat Hepatologia, Servei Aparell Digestiu, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain |

Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain |

Hospital General de Granollers, 08402 Granollers, Spain |

⁴

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain |

⁵

Unitat Gastroenterología, Servei Aparell Digestiu, Hospital Universitari Parc Taulí, Institut d’Investigacio i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain |

⁶

Estadística, Servei de Neurologia, Hospital Germans Trias i Pujol, 08916 Badalona, Spain |

⁷

Servei d’Infermeria, Unitat Hepatologia, Servei d’Aparell Digestiu, Hospital Universitari Parc Taulí, Institut d’Investigacio i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain |

⁸

Servei de Diagnòstic per la Imatge, Hospital Universitari Parc Taulí, Institut d’Investigacio i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain |

⁹

Departament de Medicina, Universitat de Vic–Universitat Central de Catalunya (UVic-UCC), 08500 Vic, Spain |

Publication type: Journal Article

Publication date: 2023-01-11

MDPI

Journal: Nutrients

scimago Q1

SJR: 1.301

CiteScore: 9.2

Impact factor: 4.8

ISSN: 20726643

DOI: 10.3390/nu15020375

Copy DOI

PubMed ID: 36678246

Food Science

Nutrition and Dietetics

Abstract

Chronic alcohol consumption is a well-known etiological factor for both chronic pancreatitis (CP) and liver cirrhosis. However, there is discussion over how often these two entities are present together in the same patient. The main goal of our study is to establish the prevalence of CP and low fecal elastase (FE-1) in patients with decompensated liver disease (DLD). In addition, we aim to identify the demographic, epidemiological and clinical factors associated with EPI and CP in patients with decompensated liver cirrhosis. This was an observational single-center study including 119 consecutive patients hospitalized for acute decompensation of cirrhosis, mostly of alcoholic etiology. Patients underwent computed tomography (CT) or magnetic resonance imaging (MRI) to assess the radiological features of CP. We also performed two FE-1 tests and complete blood tests to assess the presence of exocrine pancreatic insufficiency (EPI) and nutritional status, including micronutrients. The results of our study show that 32 patients (26.9%) had low fecal elastase suggesting EPI and 11 (9.2%) had CP. Patients meeting radiological CP criteria had lower FE-1 than patients without CP. There were no statistically significant differences in micronutrient deficiencies according to the presence of CP or not. Likewise, we did not find any statistically significant differences in micronutrient deficiencies among patients with normal and low FE-1 indicative of EPI. FE-1 alone may not be suitable for assessing EPI in patients with acute DLD. Detecting co-existing pancreatic disease may be important in a subset of patients with DLD, when the FE-1 levels are significantly low, potentially suggestive of a pancreatic anomaly. Moreover, the clinical manifestations of EPI and CP are not useful in detecting CP in DLD patients. Likewise, CP cannot explain all causes of EPI in these patients.

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