Authors (including presenting author) :
Lam YY (1), Liu PK (1), Lai SW (1), Yuen WH (1)
Affiliation :
(1)Department of Medicine & Geriatrics, Pok Oi Hospital
Keyword 1: :
Fecal Elastase
Keyword 2: :
Exocrine Pancreatic Insufficiency
Keyword 3: :
Pancreatic Disease
Introduction :
Pancreatitis causes exocrine pancreatic insufficiency (EPI) by damaging the pancreas, leading to a deficiency of digestive enzymes. People with EPI would not have enough pancreatic (digestive) enzymes to break down foods and absorb nutrients leading to malnutrition. Pancreatic elastase plays a crucial role in protein digestion and serves as an important clinical marker for exocrine pancreatic function, with stool elastase testing being the most appropriate initial test for suspected pancreatic insufficiency, as indicated by various fecal elastase level providing good evidence of EPI. However, there is no such investigation available in Hong Kong public hospitals (only available in foreign country).
With the support of the Pok Oi Hospital donation funding, feacal elastase test for early detection and diagnosis of pancreatic exocrine insufficiency implemented in Department of Medical and Geriatrics, Pok Oi Hospital since December 2024.
Objectives :
- To set up workflow for the arrangement of the Feacal Elastase Test between Pok Oi Hospital and Private Laboratory
- To confirm the diagnosis of EPI with the interception of the Feacal Elastase Test
Methodology :
Gastroenterology specialists reviewed those patients who are currently follow-up in Medical and Geriatrics Department, Pok Oi Hospital with the history of Pancreatitis. Suspected EPI patients were requested for the Feacal Elastase test and blood check during the clinic session. Our GI nurse set up a standard workflow for the referral in December 2024, and implanted in the same month. GI nurse provides patient education for the test together with the report issue. Patients are requested to send the specimen to private laboratory by own.
Result & Outcome :
The program starts from December 2024 until now and plan completed in November 2026 with total 60 beneficiaries under the donation funding. Around 50 patients fulfilled with the Pancreatitis history are requested for the test. 90% of them agreed for the investigation. 10% of them rejected mainly due to the logistic issue. There are 16 patients found the result below 200 mcg/g (i.e. moderate to severe pancreatic insufficiency). Around 30% of the patients with positive result and required further management for the insufficient.
