Abstract
Introduction. Follow-up of patients with exocrine pancreatic insufficiency can be easily performed with non-invasive test of exocrine pancreatic function - 13C-mixed triglycerides breath test (13C-MTG) and fecal elastase-1 (FELA).
Aims & Methods. 56 patients (25/31 female/male; mean age 51 years) with diagnosed or suspected chronic pancreatitis (CHP) or after severe acute pancreatitis (AP) treated with enzyme substitution were included. 13C-MTG test was performed with 250mg Glyceryl-1,3-dioctadecanoate-2-octanoate-1-13C, standardized test procedure and calculated using BMR (Basal Metabolic Rate). Fecal elastase 1 (FELA) were determined using ELISA with monoclonal antibody (ScheboTech, Germany).
Results. Laboratory verified pancreatic exocrine insufficiency with 13C-MTG lower then 30%, was found only in 3/56 subjects, FELA less then 200 ug/g was found in 11 patients.
Substitution therapy, based on these tests, are still continued only in 8/56 i.e 14.28%. Conclusions.
Measurement of fecal elastase 1 is simple, non-invasive, robust test, which well correlates with morphological, static, extent of tissue damage. 13C-MTG breath test is better in evaluation of dynamic and kinetic aspects, real digestive ability and response to stimulation. 13C-MTG breath test is, contrary to FELA, suitable to evaluate pancreatic supplementation therapy. Clinical, therapeutical and economical benefit of exocrine pancreatic function tests is in possibility to exclude pancreatic substitution therapy in more than three-fourths patients with suspected pancreatic insufficiency.