Department of Gastroenterology, Shanghai 10th People's Hospital Affiliated to Shanghai Tongji University, Shanghai, People's Republic of China.
Pancreas. 2012 Aug;41(6):922-7. doi: 10.1097/MPA.0b013e31823d7f2d.
The objective of this study was to assess pancreatic exocrine function (PEF) and morphology in patients recovering from a first episode of acute pancreatitis (AP).
Sixty-five eligible patients recovering from AP and 70 healthy volunteers were enrolled in this study. We evaluated PEF by fecal elastase 1 (FE-1) and used ultrasonography to detect pancreatic morphology for all patients and 40 controls.
Exocrine pancreatic insufficiency (EPI) incidence in the severe and mild AP subgroups was 60.5% and 39.5%, respectively. The FE-1 level in patients who had undergone surgical care was significantly lower compared with the controls (P < 0.01), whereas no difference was observed between the alcoholic and nonalcoholic groups (P > 0.05). Surprisingly, the defecation change correlated with the EPI level. In these patients, a stepwise recovery was observed over the following 2.4 years. Compared with the controls, the diameter of pancreatic duct was enlarged, and abdominal pain during recovery was found to be the independent risk factor for pancreatic duct expansion, although a significant difference was not exhibited between the AP subgroups concerning FE-1 concentration (P = 0.591).
Our results indicated that many AP patients may have long-lasting EPI and an expanded main pancreatic duct; thus, routine evaluation of PEF is warranted.
本研究旨在评估首次急性胰腺炎（AP）发作后患者的胰腺外分泌功能（PEF）和形态。
本研究纳入了 65 名符合条件的 AP 恢复期患者和 70 名健康志愿者。我们通过粪便弹性蛋白酶 1（FE-1）评估 PEF，并对所有患者和 40 名对照者进行超声检查以检测胰腺形态。
重症和轻症 AP 亚组的胰腺外分泌功能不全（EPI）发生率分别为 60.5%和 39.5%。接受手术治疗的患者的 FE-1 水平明显低于对照组（P < 0.01），而酒精性和非酒精性组之间无差异（P > 0.05）。令人惊讶的是，排便变化与 EPI 水平相关。在这些患者中，在接下来的 2.4 年内观察到逐渐恢复。与对照组相比，胰管直径增大，且恢复期腹痛是胰管扩张的独立危险因素，尽管在 AP 亚组之间，FE-1 浓度无显著差异（P = 0.591）。
我们的结果表明，许多 AP 患者可能存在长期的 EPI 和扩张的主胰管，因此需要常规评估 PEF。
