European guidelines for the diagnosis and treatment of pancreatic exocrine insufficiency: UEG, EPC, EDS, ESPEN, ESPGHAN, ESDO, and ESPCG evidence‐based recommendations
Year: 2024
Type: article
Abstract: 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.
DOI: 10.1002/ueg2.12674
Authors: J. Enrique Dominguez‐Muñoz, Miroslav Vujasinovic, Daniel de la Iglesia, Djuna Cahen, Gabriele Capurso, Natalya Gubergrits, Peter Hegyi, Pali Hungin, Johann Ockenga, Salvatore Paiella, Lukas Perkhofer, Vinciane Rebours, Jonas Rosendahl, Roberto Salvia, Isabelle Scheers, Andrea Szentesi, Stefanos Bonovas, Daniele Piovani, J. Matthias Löhr, European PEI Multidisciplinary Group
Institutions: Complejo Hospitalario Universitario de Santiago, Karolinska University Hospital, Karolinska Institutet, Hospital Universitario Puerta de Hierro Majadahonda, Erasmus MC, IRCCS Ospedale San Raffaele, INA Central Hospital, Semmelweis University, University of Szeged, University of Pecs, Newcastle University, Klinikum Bremen-Mitte, University of Verona, Universität Ulm, University Hospital Ulm, Hôpital Beaujon, Martin Luther University Halle-Wittenberg, Cliniques Universitaires Saint-Luc, UCLouvain, Humanitas University, IRCCS Humanitas Research Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,930
OpenAlex ID: W4405123656