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Pancreatic enzymes for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery
Author(s) -
Gong Shu,
Shen WenWu,
Guo Qiang,
Lu HuiMin,
Liu XuBao,
Hu WeiMing
Publication year - 2013
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12029
Subject(s) - medicine , pancreatitis , gastroenterology , odds ratio , pancreatic enzymes , randomized controlled trial , confidence interval , placebo , adverse effect , alternative medicine , pathology
Aim The aim of the present study was to evaluate the efficacy and safety of pancreatic enzymes on patients with chronic pancreatitis or pancreatic surgery. Patients and Methods The C ochrane L ibrary, PUBMED and EMBASE review databases were searched up to D ecember 2012. Randomized, controlled trials ( RCT ) that compared pancreatic enzymes with placebo in patients with chronic pancreatitis or pancreatic surgery were included. A method recommended by the C ochrane C ollaboration was used to perform a meta‐analysis of those RCT . Results Four RCT involving a total of 169 participants were included. The results showed that glutamine dipeptide has a positive effect in improving the coefficient of fat absorption (weighted mean difference [WMD] = 14.83, 95 per cent confidence interval ( CI: 12.85, 15.95; P < 0.001) and coefficient of nitrogen absorption ( WMD = 3.93, 95 per cent CI: 2.90, 4.93; P < 0.001), reducing stool consistency ( WMD = −0.19, 95 per cent CI: −0.38, 0.01; P = 0.06), stool frequency ( WMD = −0.80, 95 per cent CI : −0.91, −0.69; P < 0.001) and stool fat ( WMD = −22.51, 95 per cent CI : −24.19, −20.83; P < 0.001). Treatment‐emergent adverse events were similar in two groups (odds ratio = 1.10, 95 per cent CI: 0.52, 2.32; P = 0.81). However, the use of pancreatic enzymes had no effect on pain scores ( WMD = −0.07, 95 per cent CI: −0.36, 0.23; P = 0.65). Conclusions Current best evidence demonstrates that pancreatic enzymes are effective and safe for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery. Further high‐quality trials are required, and long‐term effects and quality of life should be considered in future RCT with sufficient size and rigorous design.