Preoperative fecal elastase-1 (FE-1) adds value in predicting post-operative pancreatic fistula: not all soft pancreas share the same risk – A prospective analysis on 105 patients

Giuliani, Tommaso; Andrianello, Stefano; Bortolato, Cecilia; Marchegiani, Giovanni; Marchi, Giulia De; Malleo, Giuseppe; Frulloni, Luca; Bassi, Claudio

doi:10.1016/j.hpb.2019.07.012

Cited by 15 publications

(16 citation statements)

References 27 publications

(24 reference statements)

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“…According to the previous reports regarding the association between PF and results of pancreatic exocrine function test, several reports revealing that higher preoperative level of FE-1 was positively associated with the developments of postoperative PF 12,30 . However, there has been no study revealing the association between the result of 13 C-labeled trioctanoin and occurrence of PF.…”

Section: Discussionmentioning

confidence: 97%

“…13 C trioctanoin breath tests have been employed on the clinical settings to evaluate the pancreatic exocrine de ciency by detecting fat malabsorption through the gut after pancreatectomies 21,22 . Until now, however, there has been few studies evaluating whether preoperative exocrine function test affect the incidence of PF after PD 12,23 .…”

Section: Discussionmentioning

confidence: 99%

“…In terms of evaluating pancreatic exocrine functions, several articles have already reported the relevancy of various pancreatic function tests [12][13][14][15][16][17] . Indeed, BT-PABA (N-benzoyl-L-trypsyl-p-aminobenzoic acid), fecal chymotrypsin, fecal elastase-1testing (FE-1), fecal fat excretion test, and 13 C-trioctanoin breath test has been clinically employed for the evaluation of it.…”

Section: Introductionmentioning

confidence: 99%

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Favorable Preoperative Exocrine Function Evaluated by 13C Trioctanoin Breath Test is a Significant Physiological Predictor of Pancreatic Fistula After Pancreaticoduodenectomy

Kato¹,

Asano²,

Ito³

et al. 2021

Preprint

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Aim The association between the pancreatic fistula (PF) after pancreaticoduodenectomy (PD) and preoperative exocrine function has yet to be elucidated. The aim of this study is to evaluate the association between the preoperative results of 13C-trioctanoin breath test and occurrence of PF, showing the clinical relevancy of the breath test to predict the PF. Method In the present study, the subject were 80 patients who underwent 13C trioctanoin breath test prior to PD from 2006 to 2018. We conducted the uni- and multivariate analyses to reveal the preoperative predictor of PF, showing the association of the 13C trioctanoin absorption and incidence of PF. Results: Among 80 patients (Age:68.0+/-11.9, male/female:46/34, pancreatic ductal adenocarcinoma: PDAC/non-PDAC: 30/50), the incidence of PF is 12.5% (10/80). When we compared the levels of 13C trioctanoin absorption between PF and non-PF group, preoperative fat absorption level is significantly higher than in the PF group than in the non-PF group (41.2+/-5.9 vs. 33.9+/-8.1, p = 0.019). Moreover, optimal cut-off value of the preoperative fat absorption level to predict PF was 38.0 (sensitivity:90%, specificity:74%, AUC:0.78, p = 0.005). Indeed, the incidence of PF was extremely higher in the patients whose value of breath test was greater than 38.0 (33%, 9/27) compared to the patients with those less than 38.0 (1.8%, 1/53). Conclusion Favorable preoperative fat absorption evaluated by 13C trioctanoin breath test is a feasible and objective predictor of PF after PD.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Favorable Preoperative Exocrine Function Evaluated by 13C Trioctanoin Breath Test is a Significant Physiological Predictor of Pancreatic Fistula After Pancreaticoduodenectomy

Kato¹,

Asano²,

Ito³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Investigating the biomarker from stool (molecules, cells, extracellular vesicles and microbiota), in a completely non-invasive way, has the potential to overcome these limitations, and a number of established assays have been proposed over the years. The majority of these, concern the detection of markers related to gastrointestinal tract pathologies ( Mima et al, 2016 ; Pous-Serrano et al, 2017 ), including hepatic ( Boursier et al, 2016 ; Zhang et al, 2019a ) and pancreatic ( Frost et al, 2019 ; Giuliani et al, 2020 ) disorders.…”

Section: Liquid Biopsymentioning

confidence: 99%

Beyond liquid biopsy: Toward non-invasive assays for distanced cancer diagnostics in pandemics

Ferrara

Zoupanou

Primiceri

et al. 2022

Biosensors and Bioelectronics

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Liquid biopsy technologies have seen a significant improvement in the last decade, offering the possibility of reliable analysis and diagnosis from several biological fluids. The use of these technologies can overcome the limits of standard clinical methods, related to invasiveness and poor patient compliance. Along with this there are now mature examples of lab-on-chips (LOC) which are available and could be an emerging and breakthrough technology for the present and near-future clinical demands that provide sample treatment, reagent addition and analysis in a sample-in/answer-out approach. The possibility of combining non-invasive liquid biopsy and LOC technologies could greatly assist in the current need for minimizing exposure and transmission risks. The recent and ongoing pandemic outbreak of SARS-CoV-2, indeed, has heavily influenced all aspects of life worldwide. Ordinary tasks have been forced to switch from “in presence” to “distanced”, limiting the possibilities for a large number of activities in all fields of life outside of the home. Unfortunately, one of the settings in which physical distancing has assumed noteworthy consequences is the screening, diagnosis and follow-up of diseases. In this review, we analyse biological fluids that are easily collected without the intervention of specialized personnel and the possibility that they may be used -or not-for innovative diagnostic assays. We consider their advantages and limitations, mainly due to stability and storage and their integration into Point-of-Care diagnostics, demonstrating that technologies in some cases are mature enough to meet current clinical needs.

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“…10,11 In addition, PE-1 has been used in the evaluation of pancreatic exocrine function. [12][13][14][15] PE-1 is a valuable biomarker for both clinical and basic applications.…”

Section: Introductionmentioning

confidence: 99%

Establishing the blood reference interval of pancreatic elastase‐1: A prospective study

Chi

Lai

Dong

et al. 2021

J of Gastro and Hepatol

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Background and Aim: Pancreatic elastase-1 (PE-1) has been investigated in pancreatic disorders. However, the reference interval (RI) of PE-1 in blood remains unconfirmed. We aimed to establish the blood RI of PE-1 in an adult population. Methods: In this prospective cross-sectional study, we enrolled 400 adults who had received the whole-body physical check-up program between May 1, 2019 and November 20, 2019. The serum and plasma PE-1 levels were measured by latex turbidimetric immunoassay in different storage conditions (fresh, refrigerated, and frozen). The 95% and 99% RI of PE-1 were calculated according to the Clinical & Laboratory Standards Institute guidelines. The correlations between PE-1 and other parameters were analyzed using multivariable regression models. Ultimately, 38 patients with acute pancreatitis were prospectively recruited as the validation cohort. Results: The PE-1 levels in fresh serum were highly correlated with those in refrigerated (R 2 = 0.998) or frozen (R 2 = 0.942) samples; however, plasma should not be suggested in frozen conditions (plasma vs serum: R 2 = 0.185). In the RI study population (202 male & 198 female participants), the median age was 52.6 (25-75% interquartile range: 43.1-61.0). The 95% and 99% RIs of PE-1 were 30.0-221.0 and 22.0-359.0 ng/dL, respectively. Triglycerides (β = 0.106, P = 0.033), lipase (β = 0.154, P = 0.007), and CA19-9 (β = 0.130, P = 0.008) were independent factors associated with PE-1. In the pancreatitis validation cohort, with a cut-off value of 359.0 ng/dL, the sensitivity and specificity were 100% and 99.8%, respectively. Conclusion:The RI of PE-1 established in this study can be used for further applications. Serum is the suggested form for frozen sample storage.

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Preoperative fecal elastase-1 (FE-1) adds value in predicting post-operative pancreatic fistula: not all soft pancreas share the same risk – A prospective analysis on 105 patients

Cited by 15 publications

References 27 publications

Favorable Preoperative Exocrine Function Evaluated by 13C Trioctanoin Breath Test is a Significant Physiological Predictor of Pancreatic Fistula After Pancreaticoduodenectomy

Favorable Preoperative Exocrine Function Evaluated by 13C Trioctanoin Breath Test is a Significant Physiological Predictor of Pancreatic Fistula After Pancreaticoduodenectomy

Beyond liquid biopsy: Toward non-invasive assays for distanced cancer diagnostics in pandemics

Establishing the blood reference interval of pancreatic elastase‐1: A prospective study

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