[Exocrine Pancreatic Insufficiency in Hepatic Cirrhosis: a Cross-Sectional Study]

. Malnutrition and sarcopenia increase morbidity and mortality in patients with liver cirrhosis. Exocrine pancreatic insufficiency may further worsen nutritional deficits.

. To evaluate exocrine pancreatic function using fecal elastase in patients with liver cirrhosis due to alcohol and other causes.

. Cross-sectional descriptive study including patients with cirrhosis who underwent fecal elastase testing at the Hospital Clínico Universidad de Chile between February 2016 and July 2023. Demographic, clinical, nutritional, and survival variables were evaluated.

. Eighty-five patients were included, with a median age of 60 years. The most frequent etiologies were alcohol consumption in 40 patients (47%) and metabolic dysfunction-associated steatotic liver disease in 21 (25%). Of the 85 patients, 88% had fecal elastase > 200 µg/g, 5% had values between 100 - 199 µg/g, and 7% had values < 100 µg/g. Fecal elastase levels were significantly lower in patients with alcohol-related cirrhosis compared with those with other etiologies (p = 0.003). Among patients with alcohol-related cirrhosis, 20% had fecal elastase < 200 µg/g (15% < 100 µg/g). Patients consuming > 20 g/day of alcohol had significantly lower fecal elastase levels (p = 0.013) than those with lower consumption.

. In patients with alcohol-related cirrhosis, we found a 20% prevalence of reduced fecal elastase. Alcohol consumption > 20 g/day was associated with lower fecal elastase levels. Considering that malnutrition and sarcopenia influence prognosis and that exocrine pancreatic insufficiency may be clinically silent, measurement of fecal elastase could be justified in patients with alcohol-related cirrhosis, particularly when nutritional deficits are present.