TY - JOUR
T1 - Long-term changes of pancreatic function in patients with complicated walled-off necrosis
AU - Nøjgaard, Camilla
AU - Werge, Mikkel
AU - Naver, Astrid
AU - Wilkens Knudsen, Anne
AU - Wewer Albrechtsen, Nicolai J
AU - Møller, Søren
AU - Gluud, Lise Lotte
AU - Novovic, Srdan
PY - 2022/10
Y1 - 2022/10
N2 - OBJECTIVES: Walled-off necrosis (WON) is a serious complication to necrotizing acute pancreatitis with a high morbidity and mortality. The aim of this study was to investigate the long-term changes in pancreatic function, metabolic function and body composition in patients with WON.MATERIAL AND METHODS: Observational study including patients with WON who underwent endoscopic transmural drainage and necrosectomy. Patients were prospectively evaluated at baseline, 3-6 months after discharge, and 12 months after discharge. Patients were characterized with fecal elastase, blood samples, computer tomography, dual energy X-ray absorptiometry and Lundh's test.RESULTS: The study includes 17 patients (11 men) with WON. The etiologies were gallstones (53%) alcohol intake (35%) and 12% had an unknown etiology. The body mass index (BMI) dropped during baseline and 3 months after discharge (p = .03) and increased 12 months after discharge (p = .002). Twelve months after discharge, 29% had mild exocrine insufficiency, 7% moderate insufficiency and 50% severe insufficiency based on the Lundh's test. Fecal elastase was <100 μg/g in 35% and <200 μg/g in 59% 12 months after discharge. Only, 24% required pancreatic enzyme substitution. Endocrine insufficiency developed in 24%. These patients also had exocrine insufficiency.CONCLUSIONS: A considerable proportion of patients with WON experience both endocrine and exocrine pancreatic insufficiency suggesting that long-term follow-up is needed in order to ensure adequate treatment.
AB - OBJECTIVES: Walled-off necrosis (WON) is a serious complication to necrotizing acute pancreatitis with a high morbidity and mortality. The aim of this study was to investigate the long-term changes in pancreatic function, metabolic function and body composition in patients with WON.MATERIAL AND METHODS: Observational study including patients with WON who underwent endoscopic transmural drainage and necrosectomy. Patients were prospectively evaluated at baseline, 3-6 months after discharge, and 12 months after discharge. Patients were characterized with fecal elastase, blood samples, computer tomography, dual energy X-ray absorptiometry and Lundh's test.RESULTS: The study includes 17 patients (11 men) with WON. The etiologies were gallstones (53%) alcohol intake (35%) and 12% had an unknown etiology. The body mass index (BMI) dropped during baseline and 3 months after discharge (p = .03) and increased 12 months after discharge (p = .002). Twelve months after discharge, 29% had mild exocrine insufficiency, 7% moderate insufficiency and 50% severe insufficiency based on the Lundh's test. Fecal elastase was <100 μg/g in 35% and <200 μg/g in 59% 12 months after discharge. Only, 24% required pancreatic enzyme substitution. Endocrine insufficiency developed in 24%. These patients also had exocrine insufficiency.CONCLUSIONS: A considerable proportion of patients with WON experience both endocrine and exocrine pancreatic insufficiency suggesting that long-term follow-up is needed in order to ensure adequate treatment.
KW - Acute necrotizing pancreatitis
KW - Lundh's test
KW - diabetes mellitus
KW - endoscopic surgery
KW - exocrine pancreatic insufficiency
KW - Lundh’s test
UR - http://www.scopus.com/inward/record.url?scp=85130260062&partnerID=8YFLogxK
U2 - 10.1080/00365521.2022.2072176
DO - 10.1080/00365521.2022.2072176
M3 - Journal article
C2 - 35546222
SN - 0036-5521
VL - 57
SP - 1257
EP - 1263
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 10
M1 - 2072176
ER -