Related Experiment Video
Updated: May 9, 2025
Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: December 14, 2019
Pancreatic congestion is associated with exocrine pancreatic function in liver cirrhosis
Masahito Kokubu1, Yoshiki Imamura1, Teru Kumagi1,2
1Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.
Aim:
Portal hypertension resulting from liver cirrhosis (LC) can lead to pancreatic congestion and impaired insulin secretion. Therefore, this prospective study aimed to assess the association between pancreatic congestion and exocrine pancreatic function in patients with LC.
Methods:
In our clinical study, pancreatic congestion and exocrine pancreatic function were evaluated using shear wave dispersion (SWD) and fecal elastase-1 (FE-1). Additionally, pancreatic acinar cells, venous walls, and fibrosis were assessed in an autopsy study.
Results:
The FE-1 levels were lower in the LC group (n = 41) than in the control group (n = 41) (312 ± 89 vs. 442 ± 100 μg/g, p < 0.001). The LC group included six patients (14.6%) with exocrine pancreatic insufficiency, whereas there were none in the control group. Pancreatic SWD values were significantly higher in the LC group than in the control group (14.8 ± 2.3 vs. 10.0 ± 1.28 [m/s]/kHz, p < 0.001). Fecal elastase-1 was significantly negatively correlated with pancreatic SWD (R = -0.55, p < 0.001). As for the autopsy study, the percentage of the trypsin-positive area was significantly lower in the LC group (n = 11) than in the control group (n = 10) (38.1 ± 10.1% vs. 26.5 ± 3.0%, p = 0.0055). The percentage of trypsin-positive area was significantly negatively correlated with the wall thickness of the pancreatic vein (R = -0.76, p < 0.001).
Conclusions:
Exocrine pancreatic function was reduced and significantly correlated with pancreatic congestion in patients with LC. Portal hypertension may affect the exocrine pancreatic function.
Related Concept Videos
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:30Liver Physiology
Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of 70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can...