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
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.
MIDER Authors
Affiliations
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
Date
2025-02-28
Type
Article
Collections
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.