Exocrine Pancreatic Insufficiency Following Acute Pancreatitis: True Association or EPIphenomenon?

摘要

Exocrine pancreatic insufficiency (EPI) is caused by inadequate delivery of pancreatic digestive enzymes to the intestinal lumen, leading to maldigestion. While longstanding chronic pancreatitis (CP) is the most well-known cause, EPI is also very common in patients with pancreatic malignancy, and in those who have undergone pancreatic resection for benign or malignant disease. Less commonly known are a number of additional conditions, which may also have EPI as a consequence (Table 1). One such condition is acute pancreatitis. While clinicians might recognize that EPI could develop after an episode of severe acute pancreatitis (AP) associated with significant pancreatic necrosis, it is becoming more apparent that EPI may occur even in those with less severe episodes of AP. The systematic review and meta-analysis published in this issue of Digestive Diseases and Sciences [ 1 ] provide an estimate of the prevalence and predictors of EPI after AP.