Recommendations from the European guidelines for the diagnosis and therapy of pancreatic exocrine insufficiency
Vujasinovic, Miroslav Iglesia, Daniel de la Dominguez-Muñoz, J Enrique Löhr, J Matthias
Vujasinovic, Miroslav
Iglesia, Daniel de la
Dominguez-Muñoz, J Enrique
Löhr, J Matthias
Affiliation
Karolinska University Hospital; University Hospital Puerta de Hierro; University Hospital of Santiago de Compostela; Karolinska Institute; Technical University of Munich; IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University; Hopital Erasme; University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj-Napoca; Ludwig Maximilian University Hospital; University of Defense Belgrade; Beatrix Children's Hospital/University Medical Center Groningen; University of Groningen; University of Amsterdam; Humanitas University; A.S. Loginov Moscow Clinical Research Center; Tver State Medical University; Erasmus University Medical Center; San Raffaele University Hospital; Acibadem Mehmet Ali Aydinlar University; University of Szeged; Dr. Balmis General University Hospital-ISABIAL; Assistance Publique – Hopitaux de Paris; Sorbonne Université; Université Catholique de Louvain; Cliniques Universitaires Saint-Luc; AGIA OLGA Hospital; University Hospital Brno; University of Ostrava; Aalborg University Hospital; Queen's University Belfast; Marmara University; Haukeland University Hospital; Johannes Wesling University Hospital; Justus-Liebig University Giessen; Ospedale Sandro Pertini; Aalborg University; University of Verona; "Carol Davila" University; Into-Sana Multi-Field Clinic Odesa; Oslo University Hospital; University of Oslo; Semmelweis University; University of Pécs; University of Sheffield; Newcastle University; Israelitic Hospital Hamburg; Moscow Clinical Scientific Center; Martin-Luther-University Halle-Wittenberg; Ulm University Hospital; Sapienza" University of Rome; Sant'Andrea University Hospital; Tampere University Hospital; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Sahlgrenska University Hospital; Hospital Universitari i Politecnic La Fe; University of Padua; Nazareth Hospital; Bar Ilan Faculty of Medicine; University Hospital of Cruces; University of Bergen; Klinikum Bremen Mitte; I.M. Sechenov First Moscow State Medical University; University of Verona Hospital Trust; University of Belgrade; University Clinic "Dr Dragisa Misovic-Dedinje"; Heim Pal National Pediatric Institute; Potenza Medical County Association; Royal Surrey County Hospital NHS Foundation Trust; Clinical Hospital Center Rijeka; University of Rijeka; Health Center Zagreb West; University Hospitals Birmingham NHS Foundation Trust; Bucharest Emergency Clinical Hospital; Medical Center Bad Hersfeld-Rotenburg; National University of Life and Environmental Sciences of Ukraine; Fondazione Policlinico Universitartio Campus BioMedico; Medical University of Vienna; St. Antonius Hospital Location Nieuwegein; CMI Dr. Udrescu Mihaela; Hadassah Hebrew University Medical Center; Technical University Munich
Other Contributors
Algul, Hana
Archibugi, Livia
Arvanitakis, Marianna
Barbu, Sonia
Beyer, Georg
Bezmarevic, Mihailo
Bodewes, Frank
Boermeester, Marja A
Bonovas, Stefano
Bordin, Dmitry
Bruno, Marco
Cahen, Djuna
Capurso, Gabriele
Ceyhan, Guralp
Czako, Laszlo
D'Amico, Ferdinando
De Madaria, Enrique
De Martino, Julian
Deprez, Pierre H
Dervenis, Christos
Dite, Petr
Drewes, Asbjorn
Duggan, Sinead N
Duman, Deniz
Engjom, Trond
Ewald, Nils
Fabian, Ovidiu
Fracasso, Pierluigi
Friess, Helmut
Frokjaer, Jens Brondum
Frulloni, Luca
Gaujoux, Sebastien
Gheorghe, Cristian
Gohy, Sophie
Gubergrits, Natalya
Hardt, Philip
Hauge, Truls
Hegyi, Peter
Hopper, Andrew
Hungin, Pali
Iglesias-Garcia, Julio
Keller, Jutta
Kiriukova, Mariia
kleef, Jorg
Kleger, Alexander
Laghi, Andrea
Larino-Noia, Jose
Laukkarinen, Johanna
Leeds, John
Lindkvist, Bjorn
Masip, Etna
Marchegiani, Giovanni
Mari, Amir
Martinez-Moneo, Emma
Mayerle, Julia
Molven, Anders
Ockenga, Johann
Okhlobystin, Alexey
Paiella, Salvatore
Panic, Nikola
Parniczky, Andrea
Perkhofer, Lukas
Pezzilli, Raffaele
Phillips, Mary
Piovani, Daniele
Poropat, Goran
Rakic Matic, Jelena
Rebours, Vinciane
Robert, Keith
Robinson, Stuart
Rosendahl, Jonas
Salvia, Roberto
Sandru, Vasile
Sauvanet, Alain
Scheers, Isabelle
Schneider, Alexander
Shvets, Oleg
Stigliano, Serena
Stimac, Davor
Strobel, Oliver
Szentesi, Andrea
Timmerhuis, Hester
Udrescu, Mihaela
Vancsa, Szilard
Veness, Vicki
Wilschanski, Michael
Witt, Heiko
Archibugi, Livia
Arvanitakis, Marianna
Barbu, Sonia
Beyer, Georg
Bezmarevic, Mihailo
Bodewes, Frank
Boermeester, Marja A
Bonovas, Stefano
Bordin, Dmitry
Bruno, Marco
Cahen, Djuna
Capurso, Gabriele
Ceyhan, Guralp
Czako, Laszlo
D'Amico, Ferdinando
De Madaria, Enrique
De Martino, Julian
Deprez, Pierre H
Dervenis, Christos
Dite, Petr
Drewes, Asbjorn
Duggan, Sinead N
Duman, Deniz
Engjom, Trond
Ewald, Nils
Fabian, Ovidiu
Fracasso, Pierluigi
Friess, Helmut
Frokjaer, Jens Brondum
Frulloni, Luca
Gaujoux, Sebastien
Gheorghe, Cristian
Gohy, Sophie
Gubergrits, Natalya
Hardt, Philip
Hauge, Truls
Hegyi, Peter
Hopper, Andrew
Hungin, Pali
Iglesias-Garcia, Julio
Keller, Jutta
Kiriukova, Mariia
kleef, Jorg
Kleger, Alexander
Laghi, Andrea
Larino-Noia, Jose
Laukkarinen, Johanna
Leeds, John
Lindkvist, Bjorn
Masip, Etna
Marchegiani, Giovanni
Mari, Amir
Martinez-Moneo, Emma
Mayerle, Julia
Molven, Anders
Ockenga, Johann
Okhlobystin, Alexey
Paiella, Salvatore
Panic, Nikola
Parniczky, Andrea
Perkhofer, Lukas
Pezzilli, Raffaele
Phillips, Mary
Piovani, Daniele
Poropat, Goran
Rakic Matic, Jelena
Rebours, Vinciane
Robert, Keith
Robinson, Stuart
Rosendahl, Jonas
Salvia, Roberto
Sandru, Vasile
Sauvanet, Alain
Scheers, Isabelle
Schneider, Alexander
Shvets, Oleg
Stigliano, Serena
Stimac, Davor
Strobel, Oliver
Szentesi, Andrea
Timmerhuis, Hester
Udrescu, Mihaela
Vancsa, Szilard
Veness, Vicki
Wilschanski, Michael
Witt, Heiko
Publication date
2025-02-28
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Research Projects
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Abstract
ackground: Pancreatic exocrine insufficiency (PEI) is defined as a reduction in pancreatic exocrine secretion below a level that allows normal digestion of nutrients. Pancreatic disease and pancreatic surgery are the main causes of PEI, but other conditions can affect the digestive function of the pancreas.
Methods: In collaboration with European Digestive Surgery (EDS), European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), European Society for Clinical Nutrition and Metabolism (ESPEN), European Society of Digestive Oncology (ESDO), and European Society of Primary Care Gastroenterology (ESPCG) the working group developed European guidelines for the diagnosis and therapy of PEI. United European Gastroenterology (UEG) provided both endorsement and financial support for the development of the guidelines.
Results: Recommendations covered topics related to the clinical management of PEI: concept, pathogenesis, clinical relevance, general diagnostic approach, general therapeutic approach, PEI secondary to chronic pancreatitis, PEI after acute pancreatitis, PEI associated with pancreatic cancer, PEI secondary to cystic fibrosis, PEI after pancreatic surgery, PEI after esophageal, gastric, and bariatric surgery, PEI in patients with type 1 and type 2 diabetes, and PEI in other conditions.
Conclusions: The European guidelines for the diagnosis and therapy of PEI provide evidence-based recommendations concerning key aspects of the etiology, diagnosis, therapy, and follow-up, based on current available evidence. These recommendations should serve as a reference standard for existing management of PEI and as a guide for future clinical research. This article summarizes the recommendations and statements.
Citation
Vujasinovic M, Iglesia D, Dominguez-Muñoz JE, Löhr JM; European PEI Multidisciplinary Group. Recommendations from the European guidelines for the diagnosis and therapy of pancreatic exocrine insufficiency. Pancreatology. 2025 May;25(3):293-300. doi: 10.1016/j.pan.2025.02.015. Epub 2025 Feb 28.
Type
Article