Review
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World J Gastroenterol. Nov 28, 2013; 19(44): 7930-7946
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7930
Exocrine pancreatic insufficiency in adults: A shared position statement of the Italian association for the study of the pancreas
Raffaele Pezzilli, Angelo Andriulli, Claudio Bassi, Gianpaolo Balzano, Maurizio Cantore, Gianfranco Delle Fave, Massimo Falconi, Luca Frulloni; the Exocrine Pancreatic Insufficiency collaborative (EPIc) Group
Raffaele Pezzilli, Angelo Andriulli, Claudio Bassi, Gianpaolo Balzano, Maurizio Cantore, Gianfranco Delle Fave, Massimo Falconi, Luca Frulloni; the Exocrine Pancreatic Insufficiency collaborative (EPIc) Group, Department of Digestive Diseases, Internal Medicine Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy
Author contributions: Pezzilli R, Andriulli A, Bassi C, Balzano G, Cantore M, Delle Fave G, Falconi M, Frulloni L analyzed the data and interpreted the results; Pezzilli R designed the study and wrote the manuscript; all the authors equally contributed to this work.
Supported by An unrestricted grant from Abbott Italia s.r.l.
Correspondence to: Raffaele Pezzilli, MD, Department of Digestive Diseases, Internal Medicine Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Telephone: +39-51-6364148 Fax: +39-51-6364148
Received: July 9, 2013
Revised: August 18, 2013
Accepted: September 16, 2013
Published online: November 28, 2013
Processing time: 154 Days and 18.3 Hours
Abstract

This is a medical position statement developed by the Exocrine Pancreatic Insufficiency collaborative group which is a part of the Italian Association for the Study of the Pancreas (AISP). We covered the main diseases associated with exocrine pancreatic insufficiency (EPI) which are of common interest to internists/gastroenterologists, oncologists and surgeons, fully aware that EPI may also occur together with many other diseases, but less frequently. A preliminary manuscript based on an extended literature search (Medline/PubMed, Cochrane Library and Google Scholar) of published reports was prepared, and key recommendations were proposed. The evidence was discussed at a dedicated meeting in Bologna during the National Meeting of the Association in October 2012. Each of the proposed recommendations and algorithms was discussed and an initial consensus was reached. The final draft of the manuscript was then sent to the AISP Council for approval and/or modification. All concerned parties approved the final version of the manuscript in June 2013.

Keywords: Exocrine pancreatic insufficiency; Chronic pancreatitis; Gastric surgery; Pancreatic surgery; Pancreatic neoplasms; Risk factors; Clinical studies

Core tip: Pancreatic exocrine insufficiency represents a condition related to pancreatic and extrapancreatic disease. We have reviewed the evidence related to the pathophysiological aspects of exocrine pancreatic diseases and we have also reported the recommendations for treating this condition in the most common pancreatic and extrapancreatic diseases. Pancreatin minimicrospheres is a drug which is cost-effective according to a survey of Polish patients, but studies demonstrating its cost-efficacy in Italy are necessary.