European guidelines for the diagnosis and treatment of pancreatic exocrine insufficiency: UEG, EPC, EDS, ESPEN, ESPGHAN, ESDO, and ESPCG evidence-based recommendations.

Autor: Dominguez-Muñoz JE; Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Vujasinovic M; Department of Medicine, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden., de la Iglesia D; Department of Gastroenterology, University Hospital Puerta de Hierro, Madrid, Spain., Cahen D; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Capurso G; Department of Gastroenterology, San Raffaele University Hospital, Milan, Italy., Gubergrits N; Into-Sana Multi-Field Clinic, Odesa, Ukraine., Hegyi P; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary.; Translational Pancreatology Research Group, Interdisciplinary Center of Excellence for Research and Development and Innovation, University of Szeged, Szeged, Hungary., Hungin P; Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK., Ockenga J; Department of Gastroenterology, Endocrinology and Clinical Nutrition, Klinikum Bremen Mitte, Bremen, Germany., Paiella S; Unit of Pancreatic Surgery, University of Verona Hospital Trust, Verona, Italy., Perkhofer L; Department of Internal Medicine I, Section of Interdisciplinary Pancreatology, Ulm University Hospital, Ulm, Germany., Rebours V; Department of Pancreatology, Beaujon Hospital, DMU Digest, AP-HP, Clichy, France., Rosendahl J; Department of Internal Medicine I, Martin Luther University, Halle, Germany., Salvia R; Unit of Pancreatic Surgery, University of Verona Hospital Trust, Verona, Italy., Scheers I; Pediatric Gastroenterology, Hepatology and Nutrition Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium., Szentesi A; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary., Bonovas S; Department of Biomedical Sciences, Humanitas University, Milan, Italy.; IRCCS Humanitas Research Hospital, Milan, Italy., Piovani D; Department of Biomedical Sciences, Humanitas University, Milan, Italy.; IRCCS Humanitas Research Hospital, Milan, Italy., Löhr JM; Department of Clinical Sciences, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Dec 05. Date of Electronic Publication: 2024 Dec 05.
DOI: 10.1002/ueg2.12674
Abstrakt: Pancreatic exocrine insufficiency (PEI) is defined as a reduction in pancreatic exocrine secretion below the level that allows the normal digestion of nutrients. Pancreatic disease and surgery are the main causes of PEI. However, other conditions and upper gastrointestinal surgery can also affect the digestive function of the pancreas. PEI can cause symptoms of nutritional malabsorption and deficiencies, which affect the quality of life and increase morbidity and mortality. These guidelines were developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. After a systematic literature review, the evidence was evaluated according to the Oxford Center for Evidence-Based Medicine and the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted on using the Delphi method. The diagnosis of PEI should be based on a global assessment of symptoms, nutritional status, and a pancreatic secretion test. Pancreatic enzyme replacement therapy (PERT), together with dietary advice and support, are the cornerstones of PEI therapy. PERT is indicated in patients with PEI that is secondary to pancreatic disease, pancreatic surgery, or other metabolic or gastroenterological conditions. Specific recommendations concerning the management of PEI under various clinical conditions are provided based on evidence and expert opinions. This evidence-based guideline summarizes the prevalence, clinical impact, and general diagnostic and therapeutic approaches for PEI, as well as the specifics of PEI in different clinical conditions. Finally, the unmet needs for future research are discussed.
(© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
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