Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis

ObjectiveThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) f...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:Gut Ročník 66; číslo 8; s. 1354 - 1355
Hlavní autoři: de la Iglesia-García, Daniel, Huang, Wei, Szatmary, Peter, Baston-Rey, Iria, Gonzalez-Lopez, Jaime, Prada-Ramallal, Guillermo, Mukherjee, Rajarshi, Nunes, Quentin M, Domínguez-Muñoz, J Enrique, Sutton, Robert
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group LTD 01.08.2017
BMJ Publishing Group
Edice:Original article
Témata:
Abdomen
Alcohol
Clinical trials
Coatings
Cystic fibrosis
Diabetes
Dietary Fats - metabolism
Drug dosages
Enzyme Therapy
Enzymes
Enzymes - administration & dosage
Excretion
Exocrine Pancreatic Insufficiency - blood
Exocrine Pancreatic Insufficiency - drug therapy
Exocrine Pancreatic Insufficiency - etiology
Feces - chemistry
Health disparities
Humans
Long-term effects
Malnutrition
Meta-analysis
Nutritional Status
Osteoporosis
Pain
Pancreas
Pancreas - enzymology
Pancreatitis
Pancreatitis, Chronic - blood
Pancreatitis, Chronic - complications
Pancreatitis, Chronic - drug therapy
Quality of Life
Randomized Controlled Trials as Topic
Studies
Surgery
NUTRIENT ABSORPTION
PANCREATITIS
PANCREATIC ENZYMES
EXOCRINE PANCREATIC FUNCTION
ISSN:0017-5749, 1468-3288, 1468-3288
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Abstract ObjectiveThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.DesignMajor databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.ResultsA total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.ConclusionsPERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.
AbstractList Objective The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP. Design Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined. Results A total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking. Conclusions PERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.
The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP. Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined. A total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I =89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I =86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking. PERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.
ObjectiveThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.DesignMajor databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.ResultsA total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.ConclusionsPERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.
The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.OBJECTIVEThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and meta-analysis of randomised controlled trials of PERT to determine the efficacy of PERT in exocrine pancreatic insufficiency (EPI) from CP.Major databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.DESIGNMajor databases were searched from 1966 to 2015 inclusive. The primary outcome was coefficient of fat absorption (CFA). Effects of PERT versus baseline and versus placebo, and of different doses, formulations and schedules were determined.A total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.RESULTSA total of 17 studies (511 patients with CP) were included and assessed qualitatively (Jadad score). Quantitative data were synthesised from 14 studies. PERT improved CFA compared with baseline (83.7±6.0 vs 63.1±15.0, p<0.00001; I2=89%) and placebo (83.2±5.5 vs 67.4±7.0, p=0.0001; I2=86%). PERT improved coefficient of nitrogen absorption, reduced faecal fat excretion, faecal nitrogen excretion, faecal weight and abdominal pain, without significant adverse events. Follow-up studies demonstrated that PERT increased serum nutritional parameters, improved GI symptoms and quality of life without significant adverse events. High-dose or enteric-coated enzymes showed a trend to greater effectiveness than low-dose or non-coated comparisons, respectively. Subgroup, sensitive and meta-regression analyses revealed that sample size, CP diagnostic criteria, study design and enzyme dose contributed to heterogeneity; data on health inequalities were lacking.PERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.CONCLUSIONSPERT is indicated to correct EPI and malnutrition in CP and may be improved by higher doses, enteric coating, administration during food and acid suppression. Further studies are required to determine optimal regimens, the impact of health inequalities and long-term effects on nutrition.
Author Nunes, Quentin M
Prada-Ramallal, Guillermo
Huang, Wei
Gonzalez-Lopez, Jaime
de la Iglesia-García, Daniel
Mukherjee, Rajarshi
Domínguez-Muñoz, J Enrique
Szatmary, Peter
Sutton, Robert
Baston-Rey, Iria
AuthorAffiliation 1 NIHR Liverpool Pancreas Biomedical Research Unit , Royal Liverpool University Hospital, University of Liverpool , Liverpool , UK
2 Department of Gastroenterology and Hepatology , University Hospital of Santiago de Compostela , Compostela , Spain
5 Department of Preventive Medicine and Public Health , University of Santiago de Compostela , Compostela , Spain
3 Department of Integrated Traditional Chinese and Western Medicine , Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University , Chengdu , China
4 Department of Pharmacy , University Hospital of Santiago de Compostela , Compostela , Spain
AuthorAffiliation_xml – name: 5 Department of Preventive Medicine and Public Health , University of Santiago de Compostela , Compostela , Spain
– name: 1 NIHR Liverpool Pancreas Biomedical Research Unit , Royal Liverpool University Hospital, University of Liverpool , Liverpool , UK
– name: 3 Department of Integrated Traditional Chinese and Western Medicine , Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University , Chengdu , China
– name: 4 Department of Pharmacy , University Hospital of Santiago de Compostela , Compostela , Spain
– name: 2 Department of Gastroenterology and Hepatology , University Hospital of Santiago de Compostela , Compostela , Spain
Author_xml – sequence: 1
  givenname: Daniel
  surname: de la Iglesia-García
  fullname: de la Iglesia-García, Daniel
  email: r.sutton@liverpool.ac.uk
  organization: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Compostela, Spain
– sequence: 2
  givenname: Wei
  surname: Huang
  fullname: Huang, Wei
  email: r.sutton@liverpool.ac.uk
  organization: Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University, Chengdu, China
– sequence: 3
  givenname: Peter
  surname: Szatmary
  fullname: Szatmary, Peter
  email: r.sutton@liverpool.ac.uk
  organization: NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
– sequence: 4
  givenname: Iria
  surname: Baston-Rey
  fullname: Baston-Rey, Iria
  email: r.sutton@liverpool.ac.uk
  organization: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Compostela, Spain
– sequence: 5
  givenname: Jaime
  surname: Gonzalez-Lopez
  fullname: Gonzalez-Lopez, Jaime
  email: r.sutton@liverpool.ac.uk
  organization: Department of Pharmacy, University Hospital of Santiago de Compostela, Compostela, Spain
– sequence: 6
  givenname: Guillermo
  surname: Prada-Ramallal
  fullname: Prada-Ramallal, Guillermo
  email: r.sutton@liverpool.ac.uk
  organization: Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Compostela, Spain
– sequence: 7
  givenname: Rajarshi
  surname: Mukherjee
  fullname: Mukherjee, Rajarshi
  email: r.sutton@liverpool.ac.uk
  organization: NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
– sequence: 8
  givenname: Quentin M
  surname: Nunes
  fullname: Nunes, Quentin M
  email: r.sutton@liverpool.ac.uk
  organization: NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
– sequence: 9
  givenname: J Enrique
  surname: Domínguez-Muñoz
  fullname: Domínguez-Muñoz, J Enrique
  email: r.sutton@liverpool.ac.uk
  organization: Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Compostela, Spain
– sequence: 10
  givenname: Robert
  orcidid: 0000-0001-6600-562X
  surname: Sutton
  fullname: Sutton, Robert
  email: r.sutton@liverpool.ac.uk
  organization: NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/27941156$$D View this record in MEDLINE/PubMed
BookMark eNqNkU9v1DAQxS1URLeFL8ABReLSS8B2nNjmgISq8keqxAXOlu1Mul4ldrC9rcKnr7dpK-gBcZrD_N7Tm3kn6MgHDwi9JvgdIU33_mqfd36sKSZd3RDaUvkMbQjrRN1QIY7QBmPC65YzeYxOUtphjIWQ5AU6plwyQtpug_zFMDir7VKFoZq1txF0drYC_3uZoIowj9rCBD5XeQtRz0vlfGW3MfhCPQqySx-qtKQM0508wrWDm0r7vpog61p7PS7JpZfo-aDHBK_u5yn6-fnix_nX-vL7l2_nny5r0zYs163oGTSypw23nQDNaWMZSMMMx70chk4YrJmxZWEMCCy0FIYBM1IyDhyaU_Rx9Z33ZoLelvxRj2qObtJxUUE79ffGu626CteqbRvMOCsGZ_cGMfzaQ8pqcsnCOGoPYZ8UES3tuo7coW-foLuwj-XgQknCRfkzpYV682eixygPVRRArICNIaUIg7Iul2eGQ0A3KoLVoXW1tq4Orau19SKlT6QP7v8U1avITLv_4W8BpF_DZg
CitedBy_id crossref_primary_10_1097_MPA_0000000000002488
crossref_primary_10_1016_S0140_6736_20_31318_0
crossref_primary_10_4236_ojim_2025_152012
crossref_primary_10_1038_s41551_020_0534_9
crossref_primary_10_1016_j_pan_2024_03_003
crossref_primary_10_1097_MPA_0000000000002480
crossref_primary_10_1186_s12876_021_01776_8
crossref_primary_10_1016_j_clnu_2020_01_004
crossref_primary_10_1016_j_gastha_2022_11_008
crossref_primary_10_1016_j_pan_2021_11_005
crossref_primary_10_1007_s00894_025_06298_8
crossref_primary_10_1055_a_2328_6190
crossref_primary_10_1016_j_jconrel_2024_06_035
crossref_primary_10_1007_s11377_025_00924_w
crossref_primary_10_1016_j_clnu_2023_12_019
crossref_primary_10_1016_j_jgr_2025_04_003
crossref_primary_10_1007_s00535_022_01911_6
crossref_primary_10_1016_j_ijbiomac_2025_140069
crossref_primary_10_1016_j_nut_2017_06_019
crossref_primary_10_14309_ajg_0000000000002266
crossref_primary_10_11603_bmbr_2706_6290_2020_2_11265
crossref_primary_10_1016_j_gastre_2020_01_001
crossref_primary_10_2147_IJGM_S504616
crossref_primary_10_1016_j_gtc_2024_08_008
crossref_primary_10_1001_jama_2019_19411
crossref_primary_10_1097_MOG_0000000000000459
crossref_primary_10_1159_000497389
crossref_primary_10_1007_s10147_024_02544_w
crossref_primary_10_1016_j_pan_2022_03_013
crossref_primary_10_1159_000541326
crossref_primary_10_4292_wjgpt_v9_i5_39
crossref_primary_10_1172_JCI146210
crossref_primary_10_1007_s40268_020_00326_z
crossref_primary_10_1016_j_gastrohep_2020_01_001
crossref_primary_10_1177_17562848241234480
crossref_primary_10_1002_ncp_10388
crossref_primary_10_1136_bmjopen_2018_025500
crossref_primary_10_1002_ueg2_12769
crossref_primary_10_1007_s00508_022_02123_x
crossref_primary_10_1016_j_surg_2018_05_040
crossref_primary_10_1038_nrdp_2017_60
crossref_primary_10_1053_j_gastro_2023_07_025
crossref_primary_10_14309_ajg_0000000000002772
crossref_primary_10_1159_000530835
crossref_primary_10_1245_s10434_021_10292_8
crossref_primary_10_1097_MD_0000000000023208
crossref_primary_10_1016_j_imlet_2023_03_007
crossref_primary_10_1089_pop_2019_0042
crossref_primary_10_1016_j_pan_2022_08_002
crossref_primary_10_1007_s10620_019_05568_9
crossref_primary_10_1097_MOG_0000000000000866
crossref_primary_10_1007_s40265_020_01360_6
crossref_primary_10_14309_ajg_0000000000000535
crossref_primary_10_1080_00365521_2018_1499801
crossref_primary_10_7861_clinmed_2020_0506
crossref_primary_10_1080_17474124_2024_2355969
crossref_primary_10_1016_j_heliyon_2025_e43379
crossref_primary_10_3904_kjim_2019_051
crossref_primary_10_1136_flgastro_2018_101071
crossref_primary_10_31146_1682_8658_ecg_195_11_5_14
crossref_primary_10_1016_j_pan_2020_11_027
crossref_primary_10_12688_f1000research_20779_1
crossref_primary_10_1080_17474124_2024_2321947
crossref_primary_10_17235_reed_2025_11517_2025
crossref_primary_10_1016_j_gtc_2017_09_004
crossref_primary_10_1007_s12664_023_01428_7
crossref_primary_10_1016_S0140_6736_24_02187_1
crossref_primary_10_1016_j_intf_2025_100049
crossref_primary_10_1097_SGA_0000000000000900
crossref_primary_10_1007_s11894_022_00837_6
crossref_primary_10_1080_03007995_2017_1389704
crossref_primary_10_1016_j_pan_2018_04_011
crossref_primary_10_1097_MD_0000000000019020
crossref_primary_10_1007_s00595_017_1557_z
crossref_primary_10_14309_ajg_0000000000000200
crossref_primary_10_1016_j_bbrc_2017_10_130
crossref_primary_10_1038_s41598_024_74694_w
crossref_primary_10_1007_s10522_025_10289_w
crossref_primary_10_26442_00403660_2025_02_203192
crossref_primary_10_1016_j_hpb_2022_05_003
crossref_primary_10_1055_a_1735_3864
crossref_primary_10_1007_s10620_023_08184_w
crossref_primary_10_1080_17474124_2020_1774365
crossref_primary_10_1016_j_ejpb_2024_114313
crossref_primary_10_1111_apt_15913
crossref_primary_10_1136_bcr_2019_231714
crossref_primary_10_1080_07853890_2022_2090601
crossref_primary_10_1053_j_gastro_2023_07_007
crossref_primary_10_7759_cureus_19764
crossref_primary_10_3389_fimmu_2025_1584107
crossref_primary_10_25040_ntsh2025_01_16
crossref_primary_10_1016_j_clnesp_2021_03_038
crossref_primary_10_1097_MPA_0000000000002359
Cites_doi 10.1002/14651858.CD006302.pub2
10.1177/0884533614528361
10.1053/j.gastro.2013.02.008
10.1046/j.1365-2036.1997.00245.x
10.1016/j.clnu.2006.01.019
10.1046/j.1365-2036.1999.00566.x
10.1097/MPA.0b013e318220ad98
10.1016/j.pan.2011.12.010
10.1038/ajg.2011.328
10.3109/00365528609034631
10.1007/s11605-012-1927-1
10.1111/j.1365-2036.2012.05202.x
10.1097/MPA.0b013e31820b971c
10.1016/j.cgh.2013.06.016
10.1136/bmj.315.7109.629
10.1038/ajg.2010.201
10.1038/nrgastro.2010.6
10.1136/gut.2006.094912
10.1016/0197-2456(86)90046-2
10.1016/0197-2456(95)00134-4
10.1177/2050640614548208
10.1136/bmj.327.7414.557
10.1111/j.1365-2036.2009.04157.x
10.1097/MPA.0000000000000237
10.1111/j.1365-2036.2008.03885.x
10.1007/BF03258451
10.1097/MPA.0000000000000131
10.1111/j.1572-0241.2004.04005.x
10.3109/00365529109025049
10.1186/1471-2288-5-13
10.1053/j.gastro.2015.08.045
10.1136/gut.2005.065946
10.1111/jep.12117
10.1038/ajg.2010.325
10.1056/NEJM197304192881603
10.1016/j.pan.2016.02.001
10.1111/j.1365-2036.2011.04631.x
10.1007/BF01311943
10.7326/0003-4819-151-4-200908180-00135
10.1017/S0029665107005848
10.1016/j.pan.2013.01.009
10.1097/00004836-200104000-00008
10.1097/00004836-200609000-00012
10.1097/01.mpa.0000226884.32957.5e
10.1111/j.1365-2036.2005.02390.x
10.1016/0016-5085(83)90070-7
10.2307/2533446
10.1136/bmj.323.7304.101
10.1136/gut.2006.093294
10.1007/BF02087549
ContentType Journal Article
Contributor Manby, Karen
Cameron, Graham
Lancaster, John
Whitby, Mary
Rodgers, Jason
Warrington, Douglas
Swindlehurst, William
Lucas, Amy
Jones, Georgia
McLaren, Tor
Rodgers, Catherine
Symon, Neil
Donaldson, Kirsty
Contributor_xml – sequence: 1
  givenname: Graham
  surname: Cameron
  fullname: Cameron, Graham
– sequence: 2
  givenname: Kirsty
  surname: Donaldson
  fullname: Donaldson, Kirsty
– sequence: 3
  givenname: Georgia
  surname: Jones
  fullname: Jones, Georgia
– sequence: 4
  givenname: John
  surname: Lancaster
  fullname: Lancaster, John
– sequence: 5
  givenname: Amy
  surname: Lucas
  fullname: Lucas, Amy
– sequence: 6
  givenname: Karen
  surname: Manby
  fullname: Manby, Karen
– sequence: 7
  givenname: Tor
  surname: McLaren
  fullname: McLaren, Tor
– sequence: 8
  givenname: Catherine
  surname: Rodgers
  fullname: Rodgers, Catherine
– sequence: 9
  givenname: Jason
  surname: Rodgers
  fullname: Rodgers, Jason
– sequence: 10
  givenname: William
  surname: Swindlehurst
  fullname: Swindlehurst, William
– sequence: 11
  givenname: Neil
  surname: Symon
  fullname: Symon, Neil
– sequence: 12
  givenname: Douglas
  surname: Warrington
  fullname: Warrington, Douglas
– sequence: 13
  givenname: Mary
  surname: Whitby
  fullname: Whitby, Mary
Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016
Copyright_xml – notice: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
– notice: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
– notice: Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
– notice: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016
CorporateAuthor NIHR Pancreas Biomedical Research Unit Patient Advisory Group
CorporateAuthor_xml – name: NIHR Pancreas Biomedical Research Unit Patient Advisory Group
DBID 9YT
ACMMV
AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
3V.
7X7
7XB
88E
88I
8AF
8FE
8FH
8FI
8FJ
8FK
ABUWG
AFKRA
AZQEC
BBNVY
BENPR
BHPHI
BTHHO
CCPQU
DWQXO
FYUFA
GHDGH
GNUQQ
HCIFZ
K9.
LK8
M0S
M1P
M2P
M7P
PHGZM
PHGZT
PJZUB
PKEHL
PPXIY
PQEST
PQGLB
PQQKQ
PQUKI
PRINS
Q9U
7X8
5PM
DOI 10.1136/gutjnl-2016-312529
DatabaseName BMJ Open Access Journals
BMJ Journals:Open Access
CrossRef
Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
ProQuest Central (Corporate)
ProQuest Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Medical Database (Alumni Edition)
Science Database (Alumni Edition)
STEM Database
ProQuest SciTech Collection
ProQuest Natural Science Collection
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central UK/Ireland
ProQuest Central Essentials
Biological Science Collection
AUTh Library subscriptions: ProQuest Central
Natural Science Collection
BMJ Journals
ProQuest One Community College
ProQuest Central Korea
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Central Student
SciTech Premium Collection
ProQuest Health & Medical Complete (Alumni)
ProQuest Biological Science Collection
Health & Medical Collection (Alumni Edition)
PML(ProQuest Medical Library)
Science Database
Biological Science Database
ProQuest Central Premium
ProQuest One Academic
ProQuest Health & Medical Research Collection
ProQuest One Academic Middle East (New)
ProQuest One Health & Nursing
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Applied & Life Sciences
ProQuest One Academic (retired)
ProQuest One Academic UKI Edition
ProQuest Central China
ProQuest Central Basic
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle CrossRef
MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
ProQuest Central Student
ProQuest One Academic Middle East (New)
ProQuest Central Essentials
ProQuest Health & Medical Complete (Alumni)
ProQuest AP Science
ProQuest Central (Alumni Edition)
SciTech Premium Collection
ProQuest One Community College
ProQuest One Health & Nursing
ProQuest Natural Science Collection
ProQuest Central China
ProQuest Central
ProQuest One Applied & Life Sciences
ProQuest Health & Medical Research Collection
Health Research Premium Collection
Health and Medicine Complete (Alumni Edition)
Natural Science Collection
ProQuest Central Korea
Health & Medical Research Collection
Biological Science Collection
ProQuest Central (New)
ProQuest Medical Library (Alumni)
ProQuest Science Journals (Alumni Edition)
ProQuest Biological Science Collection
ProQuest Central Basic
ProQuest Science Journals
ProQuest One Academic Eastern Edition
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
Biological Science Database
ProQuest SciTech Collection
ProQuest Hospital Collection (Alumni)
ProQuest Health & Medical Complete
ProQuest Medical Library
ProQuest One Academic UKI Edition
BMJ Journals
ProQuest One Academic
ProQuest One Academic (New)
ProQuest Central (Alumni)
MEDLINE - Academic
DatabaseTitleList ProQuest Central Student
MEDLINE

MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: BENPR
  name: ProQuest Central
  url: https://www.proquest.com/central
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1468-3288
EndPage 1355
ExternalDocumentID PMC5530474
27941156
10_1136_gutjnl_2016_312529
gutjnl
Genre Meta-Analysis
Systematic Review
Journal Article
GroupedDBID ---
.55
.GJ
.VT
08G
0R~
18M
29I
2WC
354
39C
3O-
4.4
40O
53G
5GY
5VS
7X7
7~S
88E
88I
8AF
8F7
8FE
8FH
8FI
8FJ
8R4
8R5
9YT
AAHLL
AAKAS
AAOJX
AAUVZ
AAWJN
AAYEP
ABAAH
ABKDF
ABMQD
ABOCM
ABTFR
ABUWG
ABVAJ
ACGFO
ACGFS
ACGOD
ACGTL
ACHTP
ACMFJ
ACMMV
ACOAB
ACOFX
ACQSR
ACTZY
ADBBV
ADCEG
ADFRT
ADUGQ
ADZCM
AENEX
AFKRA
AFWFF
AGQPQ
AHMBA
AHNKE
AHQMW
AI.
AJYBZ
ALIPV
ALMA_UNASSIGNED_HOLDINGS
ASPBG
AVWKF
AZFZN
AZQEC
BAWUL
BBNVY
BENPR
BHPHI
BLJBA
BOMFT
BPHCQ
BTFSW
BTHHO
BVXVI
C1A
C45
CAG
CCPQU
COF
CS3
CXRWF
DIK
DU5
DWQXO
E3Z
EBS
EJD
F5P
FD8
FEDTE
FYUFA
GNUQQ
GX1
H13
HAJ
HCIFZ
HMCUK
HVGLF
HYE
HZ~
IAO
IEA
IH2
IHR
INH
INR
IOF
ITC
J5H
KQ8
L7B
LK8
M1P
M2P
M7P
N9A
NTWIH
NXWIF
O9-
OK1
OVD
P2P
PHGZT
PQQKQ
PROAC
PSQYO
Q2X
R53
RHI
RMJ
RPM
RV8
TEORI
TR2
UKHRP
UYXKK
V24
VH1
VM9
VVN
W8F
WH7
WOQ
X7M
YFH
YOC
YQY
ZGI
ZXP
ZY1
AAYXX
ACQHZ
AERUA
AFFHD
CITATION
PHGZM
PJZUB
PPXIY
PQGLB
ADGHP
CGR
CUY
CVF
ECM
EIF
NPM
3V.
7XB
8FK
K9.
PKEHL
PQEST
PQUKI
PRINS
Q9U
7X8
PUEGO
5PM
ID FETCH-LOGICAL-b534t-58d4e39d237c68ea723c4e9b4b70d9ff68b0a4bca72bbe808a98b4e4b9947e7e3
IEDL.DBID M7P
ISICitedReferencesCount 136
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000405191200018&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 0017-5749
1468-3288
IngestDate Tue Nov 04 02:01:31 EST 2025
Wed Oct 01 14:42:44 EDT 2025
Tue Oct 07 07:08:15 EDT 2025
Mon Jul 21 05:55:26 EDT 2025
Tue Nov 18 20:47:30 EST 2025
Sat Nov 29 07:32:59 EST 2025
Thu Apr 24 23:06:58 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 8
Keywords NUTRIENT ABSORPTION
PANCREATITIS
PANCREATIC ENZYMES
EXOCRINE PANCREATIC FUNCTION
Language English
License This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-b534t-58d4e39d237c68ea723c4e9b4b70d9ff68b0a4bca72bbe808a98b4e4b9947e7e3
Notes ObjectType-Article-2
SourceType-Scholarly Journals-1
content type line 14
ObjectType-Feature-3
ObjectType-Evidence Based Healthcare-1
ObjectType-Article-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ObjectType-Undefined-4
ORCID 0000-0001-6600-562X
OpenAccessLink https://pubmed.ncbi.nlm.nih.gov/PMC5530474
PMID 27941156
PQID 1917815622
PQPubID 2041069
PageCount 2
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_5530474
proquest_miscellaneous_1852666174
proquest_journals_1917815622
pubmed_primary_27941156
crossref_citationtrail_10_1136_gutjnl_2016_312529
crossref_primary_10_1136_gutjnl_2016_312529
bmj_primary_10_1136_gutjnl_2016_312529
PublicationCentury 2000
PublicationDate 2017-08-01
PublicationDateYYYYMMDD 2017-08-01
PublicationDate_xml – month: 08
  year: 2017
  text: 2017-08-01
  day: 01
PublicationDecade 2010
PublicationPlace England
PublicationPlace_xml – name: England
– name: London
– name: BMA House, Tavistock Square, London, WC1H 9JR
PublicationSeriesTitle Original article
PublicationTitle Gut
PublicationTitleAlternate Gut
PublicationYear 2017
Publisher BMJ Publishing Group LTD
BMJ Publishing Group
Publisher_xml – name: BMJ Publishing Group LTD
– name: BMJ Publishing Group
References Forsmark 2013; 144
Stratton 2007; 66
Moher, Liberati, Tetzlaff 2009; 151
Sterne, Egger, Smith 2001; 323
Taylor, Gardner, Waljee 2010; 31
Tignor, Wu, Whitlock 2010; 105
Gubergrits, Malecka-Panas, Lehman 2011; 33
Lévy, Domínguez-Muñoz, Imrie 2014; 2
Waljee, Dimagno, Wu 2009; 29
Begg, Mazumdar 1994; 50
Toskes, Secci, Thieroff-Ekerdt 2011; 40
Dutta, Rubin, Harvey 1983; 84
Domínguez-Muñoz, Iglesias-García, Iglesias-Rey 2005; 21
Egger, Davey Smith, Schneider 1997; 315
Yadav, Timmons, Benson 2011; 106
Whitcomb, Lehman, Vasileva 2010; 105
Sikkens, Cahen, van Eijck 2012; 16
Delhaye, Meuris, Gohimont 1996; 8
Conwell, Lee, Yadav 2014; 43
Meier, Ockenga, Pertkiewicz 2006; 25
Hall, Garcea, Webb 2014; 20
Sikkens, Cahen, van Eijck 2012; 12
Wehler, Nichterlein, Fischer 2004; 99
Vecht, Symersky, Lamers 2006; 40
Shafiq, Rana, Bhasin 2009
DerSimonian, Laird 1986; 7
Peery, Crockett, Barritt 2015; 149
Bruno, Rauws, Hoek 1994; 39
Hozo, Djulbegovic, Hozo 2005; 5
Ramesh, Reddy, Bhatia 2013; 13
Jørgensen, Pedersen, Worning 1991; 26
Keller, Brückel, Jahr 2011; 40
Halgreen, Pedersen, Worning 1986; 21
Graham 1979; 24
Gullo, Tassoni, Mazzoni 1996; 91
Lankisch, Lembcke, Göke 1986; 24
2006
Halm, Löser, Löhr 1999; 13
Higgins, Thompson, Deeks 2003; 327
Gouerou, Dain, Parrondo 1989; 5
DiMagno, Go, Summerskill 1973; 288
Whitcomb, Frulloni, Garg 2016; 16
Safdi, Bekal, Martin 2006; 33
Duggan, Smyth, O'Sullivan 2014; 29
Yadav, Whitcomb 2010; 7
Paris 1993; 5
Dominguez-Muñoz, Iglesias-García, Iglesias-Rey 2006; 55
Keller, Layer 2005; 54
Opekun, Sutton, Graham 1997; 11
Thorat, Reddy, Bhatia 2012; 36
Duggan, Smyth, Murphy 2014; 12
O'Keefe, Cariem, Levy 2001; 32
D'Haese, Ceyhan, Demir 2014; 43
Jadad, Moore, Carroll 1996; 17
Gullo (2025090714371012000_66.8.1354.13) 1996; 91
Paris (2025090714371012000_66.8.1354.38) 1993; 5
2025090714371012000_66.8.1354.50
2025090714371012000_66.8.1354.51
2025090714371012000_66.8.1354.52
Hall (2025090714371012000_66.8.1354.8) 2014; 20
2025090714371012000_66.8.1354.10
2025090714371012000_66.8.1354.11
2025090714371012000_66.8.1354.12
2025090714371012000_66.8.1354.15
2025090714371012000_66.8.1354.16
2025090714371012000_66.8.1354.18
2025090714371012000_66.8.1354.19
Jørgensen (2025090714371012000_66.8.1354.37) 1991; 26
2025090714371012000_66.8.1354.20
2025090714371012000_66.8.1354.21
2025090714371012000_66.8.1354.22
2025090714371012000_66.8.1354.23
2025090714371012000_66.8.1354.24
Halgreen (2025090714371012000_66.8.1354.35) 1986; 21
2025090714371012000_66.8.1354.25
2025090714371012000_66.8.1354.26
2025090714371012000_66.8.1354.27
2025090714371012000_66.8.1354.28
2025090714371012000_66.8.1354.29
Delhaye (2025090714371012000_66.8.1354.39) 1996; 8
Whitcomb (2025090714371012000_66.8.1354.54) 2016; 16
Dutta (2025090714371012000_66.8.1354.33) 1983; 84
Opekun (2025090714371012000_66.8.1354.40) 1997; 11
2025090714371012000_66.8.1354.30
2025090714371012000_66.8.1354.31
Sikkens (2025090714371012000_66.8.1354.17) 2012; 12
Graham (2025090714371012000_66.8.1354.32) 1979; 24
Gouerou (2025090714371012000_66.8.1354.36) 1989; 5
Stratton (2025090714371012000_66.8.1354.14) 2007; 66
D'Haese (2025090714371012000_66.8.1354.53) 2014; 43
2025090714371012000_66.8.1354.41
2025090714371012000_66.8.1354.42
2025090714371012000_66.8.1354.43
2025090714371012000_66.8.1354.5
2025090714371012000_66.8.1354.44
2025090714371012000_66.8.1354.4
2025090714371012000_66.8.1354.45
2025090714371012000_66.8.1354.7
2025090714371012000_66.8.1354.46
2025090714371012000_66.8.1354.6
2025090714371012000_66.8.1354.47
2025090714371012000_66.8.1354.1
2025090714371012000_66.8.1354.48
Lankisch (2025090714371012000_66.8.1354.34) 1986; 24
2025090714371012000_66.8.1354.49
2025090714371012000_66.8.1354.3
2025090714371012000_66.8.1354.2
Keller (2025090714371012000_66.8.1354.9) 2005; 54
28939662 - Gut. 2018 Jul;67(7):1365-1366. doi: 10.1136/gutjnl-2017-315067.
28130312 - Gut. 2017 Aug;66(8):1354-1355. doi: 10.1136/gutjnl-2016-313455.
References_xml – start-page: CD006302
  year: 2009
  article-title: Pancreatic enzymes for chronic pancreatitis
  publication-title: Cochrane Database Syst Rev
  doi: 10.1002/14651858.CD006302.pub2
– volume: 29
  start-page: 348
  year: 2014
  article-title: The prevalence of malnutrition and fat-soluble vitamin deficiencies in chronic pancreatitis
  publication-title: Nutr Clin Pract
  doi: 10.1177/0884533614528361
– volume: 144
  start-page: 1282
  year: 2013
  article-title: Management of chronic pancreatitis
  publication-title: Gastroenterology
  doi: 10.1053/j.gastro.2013.02.008
– volume: 11
  start-page: 981
  year: 1997
  article-title: Lack of dose-response with Pancrease MT for the treatment of exocrine pancreatic insufficiency in adults
  publication-title: Aliment Pharmacol Ther
  doi: 10.1046/j.1365-2036.1997.00245.x
– volume: 50
  start-page: 1088
  year: 1994
  article-title: Operating characteristics of a rank correlation test for publication bias
  publication-title: Biometrics
– volume: 25
  start-page: 275
  year: 2006
  article-title: ESPEN guidelines on enteral nutrition: pancreas
  publication-title: Clin Nutr
  doi: 10.1016/j.clnu.2006.01.019
– volume: 13
  start-page: 951
  year: 1999
  article-title: A double-blind, randomized, multicentre, crossover study to prove equivalence of pancreatin minimicrospheres versus microspheres in exocrine pancreatic insufficiency
  publication-title: Aliment Pharmacol Ther
  doi: 10.1046/j.1365-2036.1999.00566.x
– volume: 40
  start-page: 1201
  year: 2011
  article-title: A modified (1)(3)C-mixed triglyceride breath test detects moderate pancreatic exocrine insufficiency
  publication-title: Pancreas
  doi: 10.1097/MPA.0b013e318220ad98
– volume: 12
  start-page: 71
  year: 2012
  article-title: Patients with exocrine insufficiency due to chronic pancreatitis are undertreated: a Dutch national survey
  publication-title: Pancreatology
  doi: 10.1016/j.pan.2011.12.010
– volume: 106
  start-page: 2192
  year: 2011
  article-title: Incidence, prevalence, and survival of chronic pancreatitis: a population-based study
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2011.328
– volume: 21
  start-page: 104
  year: 1986
  article-title: Symptomatic effect of pancreatic enzyme therapy in patients with chronic pancreatitis
  publication-title: Scand J Gastroenterol
  doi: 10.3109/00365528609034631
– volume: 16
  start-page: 1487
  year: 2012
  article-title: The daily practice of pancreatic enzyme replacement therapy after pancreatic surgery: a northern European survey: enzyme replacement after surgery
  publication-title: J Gastrointest Surg
  doi: 10.1007/s11605-012-1927-1
– volume: 36
  start-page: 426
  year: 2012
  article-title: Randomised clinical trial: the efficacy and safety of pancreatin enteric-coated minimicrospheres (Creon 40000 MMS) in patients with pancreatic exocrine insufficiency due to chronic pancreatitis—a double-blind, placebo-controlled study
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2012.05202.x
– volume: 40
  start-page: 376
  year: 2011
  article-title: Efficacy of a novel pancreatic enzyme product, EUR-1008 (Zenpep), in patients with exocrine pancreatic insufficiency due to chronic pancreatitis
  publication-title: Pancreas
  doi: 10.1097/MPA.0b013e31820b971c
– volume: 12
  start-page: 219
  year: 2014
  article-title: High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis
  publication-title: Clin Gastroenterol Hepatol
  doi: 10.1016/j.cgh.2013.06.016
– volume: 315
  start-page: 629
  year: 1997
  article-title: Bias in meta-analysis detected by a simple, graphical test
  publication-title: BMJ
  doi: 10.1136/bmj.315.7109.629
– volume: 105
  start-page: 2276
  year: 2010
  article-title: Pancrelipase delayed-release capsules (CREON) for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery: a double-blind randomized trial
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2010.201
– volume: 7
  start-page: 131
  year: 2010
  article-title: The role of alcohol and smoking in pancreatitis
  publication-title: Nat Rev Gastroenterol Hepatol
  doi: 10.1038/nrgastro.2010.6
– volume: 55
  start-page: 1056
  year: 2006
  article-title: Optimising the therapy of exocrine pancreatic insufficiency by the association of a proton pump inhibitor to enteric coated pancreatic extracts
  publication-title: Gut
  doi: 10.1136/gut.2006.094912
– volume: 7
  start-page: 177
  year: 1986
  article-title: Meta-analysis in clinical trials
  publication-title: Control Clin Trials
  doi: 10.1016/0197-2456(86)90046-2
– volume: 17
  start-page: 1
  year: 1996
  article-title: Assessing the quality of reports of randomized clinical trials: is blinding necessary?
  publication-title: Control Clin Trials
  doi: 10.1016/0197-2456(95)00134-4
– volume: 2
  start-page: 345
  year: 2014
  article-title: Epidemiology of chronic pancreatitis: burden of the disease and consequences
  publication-title: United European Gastroenterol J
  doi: 10.1177/2050640614548208
– volume: 84
  start-page: 476
  year: 1983
  article-title: Comparative evaluation of the therapeutic efficacy of a pH-sensitive enteric coated pancreatic enzyme preparation with conventional pancreatic enzyme therapy in the treatment of exocrine pancreatic insufficiency
  publication-title: Gastroenterology
– volume: 91
  start-page: 759
  year: 1996
  article-title: Increased prevalence of aortic calcification in chronic pancreatitis
  publication-title: Am J Gastroenterol
– volume: 327
  start-page: 557
  year: 2003
  article-title: Measuring inconsistency in meta-analyses
  publication-title: BMJ
  doi: 10.1136/bmj.327.7414.557
– volume: 323
  start-page: 101
  year: 2001
  article-title: Systematic reviews in health care: investigating and dealing with publication and other biases in meta-analysis
  publication-title: BMJ
– volume: 31
  start-page: 57
  year: 2010
  article-title: Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2009.04157.x
– volume: 43
  start-page: 1143
  year: 2014
  article-title: American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines
  publication-title: Pancreas
  doi: 10.1097/MPA.0000000000000237
– volume: 29
  start-page: 235
  year: 2009
  article-title: Systematic review: pancreatic enzyme treatment of malabsorption associated with chronic pancreatitis
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2008.03885.x
– volume: 5
  start-page: 229
  year: 1993
  article-title: A multicentre double-blind placebo-controlled study of the effect of a pancreatic enzyme formulation (Panzytrat 25000) on impaired lipid digestion in adults with chronic pancreatitis
  publication-title: Drug Investigation
  doi: 10.1007/BF03258451
– volume: 39
  start-page: 988
  year: 1994
  article-title: Comparative effects of adjuvant cimetidine and omeprazole during pancreatic enzyme replacement therapy
  publication-title: Dig Dis Sci
– volume: 43
  start-page: 834
  year: 2014
  article-title: Pancreatic enzyme replacement therapy in patients with exocrine pancreatic insufficiency due to chronic pancreatitis: a 1-year disease management study on symptom control and quality of life
  publication-title: Pancreas
  doi: 10.1097/MPA.0000000000000131
– volume: 99
  start-page: 138
  year: 2004
  article-title: Factors associated with health-related quality of life in chronic pancreatitis
  publication-title: Am J Gastroenterol
  doi: 10.1111/j.1572-0241.2004.04005.x
– volume: 26
  start-page: 321
  year: 1991
  article-title: Monitoring the effect of substitution therapy in patients with exocrine pancreatic insufficiency
  publication-title: Scand J Gastroenterol
  doi: 10.3109/00365529109025049
– volume: 5
  start-page: 13
  year: 2005
  article-title: Estimating the mean and variance from the median, range, and the size of a sample
  publication-title: BMC Med Res Methodol
  doi: 10.1186/1471-2288-5-13
– volume: 149
  start-page: 1731
  year: 2015
  article-title: Burden of gastrointestinal, liver, and pancreatic diseases in the United States
  publication-title: Gastroenterology
  doi: 10.1053/j.gastro.2015.08.045
– volume: 54
  start-page: vi1
  issue: 6
  year: 2005
  article-title: Human pancreatic exocrine response to nutrients in health and disease
  publication-title: Gut
  doi: 10.1136/gut.2005.065946
– volume: 20
  start-page: 203
  year: 2014
  article-title: The socio-economic impact of chronic pancreatitis: a systematic review
  publication-title: J Eval Clin Pract
  doi: 10.1111/jep.12117
– volume: 105
  start-page: 2680
  year: 2010
  article-title: High prevalence of low-trauma fracture in chronic pancreatitis
  publication-title: Am J Gastroenterol
  doi: 10.1038/ajg.2010.325
– volume: 288
  start-page: 813
  year: 1973
  article-title: Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency
  publication-title: N Engl J Med
  doi: 10.1056/NEJM197304192881603
– volume: 16
  start-page: 218
  year: 2016
  article-title: Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition
  publication-title: Pancreatology
  doi: 10.1016/j.pan.2016.02.001
– volume: 33
  start-page: 1152
  year: 2011
  article-title: A 6-month, open-label clinical trial of pancrelipase delayed-release capsules (Creon) in patients with exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2011.04631.x
– volume: 24
  start-page: 906
  year: 1979
  article-title: An enteric-coated pancreatic enzyme preparation that works
  publication-title: Dig Dis Sci
  doi: 10.1007/BF01311943
– volume: 151
  start-page: 264
  year: 2009
  article-title: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
  publication-title: Ann Intern Med
  doi: 10.7326/0003-4819-151-4-200908180-00135
– volume: 66
  start-page: 522
  year: 2007
  article-title: Malnutrition: another health inequality?
  publication-title: Proc Nutr Soc
  doi: 10.1017/S0029665107005848
– volume: 5
  start-page: 45
  year: 1989
  article-title: Alipase versus nonenteric-coated enzymes in pancreatic insufficiency. A French multicenter crossover comparative study
  publication-title: Int J Pancreatol
– volume: 13
  start-page: 133
  year: 2013
  article-title: A 51-week, open-label clinical trial in India to assess the efficacy and safety of pancreatin 40000 enteric-coated minimicrospheres in patients with pancreatic exocrine insufficiency due to chronic pancreatitis
  publication-title: Pancreatology
  doi: 10.1016/j.pan.2013.01.009
– volume: 24
  start-page: 753
  year: 1986
  article-title: Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage?
  publication-title: Z Gastroenterol
– volume: 32
  start-page: 319
  year: 2001
  article-title: The exacerbation of pancreatic endocrine dysfunction by potent pancreatic exocrine supplements in patients with chronic pancreatitis
  publication-title: J Clin Gastroenterol
  doi: 10.1097/00004836-200104000-00008
– year: 2006
– volume: 40
  start-page: 721
  year: 2006
  article-title: Efficacy of lower than standard doses of pancreatic enzyme supplementation therapy during acid inhibition in patients with pancreatic exocrine insufficiency
  publication-title: J Clin Gastroenterol
  doi: 10.1097/00004836-200609000-00012
– volume: 33
  start-page: 156
  year: 2006
  article-title: The effects of oral pancreatic enzymes (Creon 10 capsule) on steatorrhea: a multicenter, placebo-controlled, parallel group trial in subjects with chronic pancreatitis
  publication-title: Pancreas
  doi: 10.1097/01.mpa.0000226884.32957.5e
– volume: 8
  start-page: 699
  year: 1996
  article-title: Comparative evaluation of a high lipase pancreatic enzyme preparation and a standard pancreatic supplement for treating exocrine pancreatic insufficiency in chronic pancreatitis
  publication-title: Eur J Gastroenterol Hepatol
– volume: 21
  start-page: 993
  year: 2005
  article-title: Effect of the administration schedule on the therapeutic efficacy of oral pancreatic enzyme supplements in patients with exocrine pancreatic insufficiency: a randomized, three-way crossover study
  publication-title: Aliment Pharmacol Ther
  doi: 10.1111/j.1365-2036.2005.02390.x
– volume: 84
  start-page: 476
  year: 1983
  ident: 2025090714371012000_66.8.1354.33
  article-title: Comparative evaluation of the therapeutic efficacy of a pH-sensitive enteric coated pancreatic enzyme preparation with conventional pancreatic enzyme therapy in the treatment of exocrine pancreatic insufficiency
  publication-title: Gastroenterology
  doi: 10.1016/0016-5085(83)90070-7
– volume: 26
  start-page: 321
  year: 1991
  ident: 2025090714371012000_66.8.1354.37
  article-title: Monitoring the effect of substitution therapy in patients with exocrine pancreatic insufficiency
  publication-title: Scand J Gastroenterol
  doi: 10.3109/00365529109025049
– ident: 2025090714371012000_66.8.1354.6
  doi: 10.1038/ajg.2011.328
– ident: 2025090714371012000_66.8.1354.28
  doi: 10.1136/bmj.327.7414.557
– volume: 21
  start-page: 104
  year: 1986
  ident: 2025090714371012000_66.8.1354.35
  article-title: Symptomatic effect of pancreatic enzyme therapy in patients with chronic pancreatitis
  publication-title: Scand J Gastroenterol
  doi: 10.3109/00365528609034631
– volume: 66
  start-page: 522
  year: 2007
  ident: 2025090714371012000_66.8.1354.14
  article-title: Malnutrition: another health inequality?
  publication-title: Proc Nutr Soc
  doi: 10.1017/S0029665107005848
– volume: 24
  start-page: 906
  year: 1979
  ident: 2025090714371012000_66.8.1354.32
  article-title: An enteric-coated pancreatic enzyme preparation that works
  publication-title: Dig Dis Sci
  doi: 10.1007/BF01311943
– ident: 2025090714371012000_66.8.1354.25
  doi: 10.1016/0197-2456(95)00134-4
– ident: 2025090714371012000_66.8.1354.27
  doi: 10.1016/0197-2456(86)90046-2
– ident: 2025090714371012000_66.8.1354.19
  doi: 10.1016/j.clnu.2006.01.019
– volume: 91
  start-page: 759
  year: 1996
  ident: 2025090714371012000_66.8.1354.13
  article-title: Increased prevalence of aortic calcification in chronic pancreatitis
  publication-title: Am J Gastroenterol
– ident: 2025090714371012000_66.8.1354.47
  doi: 10.1097/MPA.0b013e31820b971c
– ident: 2025090714371012000_66.8.1354.7
  doi: 10.1053/j.gastro.2015.08.045
– ident: 2025090714371012000_66.8.1354.22
  doi: 10.1111/j.1365-2036.2008.03885.x
– ident: 2025090714371012000_66.8.1354.30
  doi: 10.2307/2533446
– ident: 2025090714371012000_66.8.1354.45
  doi: 10.1097/01.mpa.0000226884.32957.5e
– volume: 5
  start-page: 45
  year: 1989
  ident: 2025090714371012000_66.8.1354.36
  article-title: Alipase versus nonenteric-coated enzymes in pancreatic insufficiency. A French multicenter crossover comparative study
  publication-title: Int J Pancreatol
– ident: 2025090714371012000_66.8.1354.50
  doi: 10.1016/j.pan.2013.01.009
– ident: 2025090714371012000_66.8.1354.26
  doi: 10.1186/1471-2288-5-13
– ident: 2025090714371012000_66.8.1354.48
  doi: 10.1111/j.1365-2036.2012.05202.x
– ident: 2025090714371012000_66.8.1354.21
  doi: 10.1002/14651858.CD006302.pub2
– volume: 8
  start-page: 699
  year: 1996
  ident: 2025090714371012000_66.8.1354.39
  article-title: Comparative evaluation of a high lipase pancreatic enzyme preparation and a standard pancreatic supplement for treating exocrine pancreatic insufficiency in chronic pancreatitis
  publication-title: Eur J Gastroenterol Hepatol
– ident: 2025090714371012000_66.8.1354.20
– volume: 5
  start-page: 229
  year: 1993
  ident: 2025090714371012000_66.8.1354.38
  article-title: A multicentre double-blind placebo-controlled study of the effect of a pancreatic enzyme formulation (Panzytrat 25000) on impaired lipid digestion in adults with chronic pancreatitis
  publication-title: Drug Investigation
  doi: 10.1007/BF03258451
– volume: 43
  start-page: 834
  year: 2014
  ident: 2025090714371012000_66.8.1354.53
  article-title: Pancreatic enzyme replacement therapy in patients with exocrine pancreatic insufficiency due to chronic pancreatitis: a 1-year disease management study on symptom control and quality of life
  publication-title: Pancreas
  doi: 10.1097/MPA.0000000000000131
– ident: 2025090714371012000_66.8.1354.2
  doi: 10.1097/MPA.0000000000000237
– volume: 54
  start-page: vi1
  issue: 6
  year: 2005
  ident: 2025090714371012000_66.8.1354.9
  article-title: Human pancreatic exocrine response to nutrients in health and disease
  publication-title: Gut
  doi: 10.1136/gut.2005.065946
– ident: 2025090714371012000_66.8.1354.4
  doi: 10.1038/nrgastro.2010.6
– ident: 2025090714371012000_66.8.1354.1
  doi: 10.1053/j.gastro.2013.02.008
– volume: 16
  start-page: 218
  year: 2016
  ident: 2025090714371012000_66.8.1354.54
  article-title: Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition
  publication-title: Pancreatology
  doi: 10.1016/j.pan.2016.02.001
– ident: 2025090714371012000_66.8.1354.29
  doi: 10.1136/bmj.323.7304.101
– ident: 2025090714371012000_66.8.1354.5
  doi: 10.1111/j.1572-0241.2004.04005.x
– ident: 2025090714371012000_66.8.1354.24
  doi: 10.7326/0003-4819-151-4-200908180-00135
– volume: 24
  start-page: 753
  year: 1986
  ident: 2025090714371012000_66.8.1354.34
  article-title: Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage?
  publication-title: Z Gastroenterol
– ident: 2025090714371012000_66.8.1354.51
  doi: 10.1136/gut.2006.093294
– ident: 2025090714371012000_66.8.1354.3
  doi: 10.1177/2050640614548208
– ident: 2025090714371012000_66.8.1354.18
  doi: 10.1007/s11605-012-1927-1
– ident: 2025090714371012000_66.8.1354.16
  doi: 10.1097/MPA.0b013e318220ad98
– volume: 11
  start-page: 981
  year: 1997
  ident: 2025090714371012000_66.8.1354.40
  article-title: Lack of dose-response with Pancrease MT for the treatment of exocrine pancreatic insufficiency in adults
  publication-title: Aliment Pharmacol Ther
  doi: 10.1046/j.1365-2036.1997.00245.x
– ident: 2025090714371012000_66.8.1354.44
  doi: 10.1097/00004836-200609000-00012
– ident: 2025090714371012000_66.8.1354.15
  doi: 10.1056/NEJM197304192881603
– ident: 2025090714371012000_66.8.1354.11
  doi: 10.1016/j.cgh.2013.06.016
– ident: 2025090714371012000_66.8.1354.23
  doi: 10.1111/j.1365-2036.2009.04157.x
– volume: 12
  start-page: 71
  year: 2012
  ident: 2025090714371012000_66.8.1354.17
  article-title: Patients with exocrine insufficiency due to chronic pancreatitis are undertreated: a Dutch national survey
  publication-title: Pancreatology
  doi: 10.1016/j.pan.2011.12.010
– ident: 2025090714371012000_66.8.1354.43
  doi: 10.1111/j.1365-2036.2005.02390.x
– ident: 2025090714371012000_66.8.1354.49
  doi: 10.1111/j.1365-2036.2011.04631.x
– ident: 2025090714371012000_66.8.1354.52
  doi: 10.1007/BF02087549
– ident: 2025090714371012000_66.8.1354.42
  doi: 10.1097/00004836-200104000-00008
– ident: 2025090714371012000_66.8.1354.10
  doi: 10.1177/0884533614528361
– ident: 2025090714371012000_66.8.1354.12
  doi: 10.1038/ajg.2010.325
– volume: 20
  start-page: 203
  year: 2014
  ident: 2025090714371012000_66.8.1354.8
  article-title: The socio-economic impact of chronic pancreatitis: a systematic review
  publication-title: J Eval Clin Pract
  doi: 10.1111/jep.12117
– ident: 2025090714371012000_66.8.1354.46
  doi: 10.1038/ajg.2010.201
– ident: 2025090714371012000_66.8.1354.41
  doi: 10.1046/j.1365-2036.1999.00566.x
– ident: 2025090714371012000_66.8.1354.31
  doi: 10.1136/bmj.315.7109.629
– reference: 28130312 - Gut. 2017 Aug;66(8):1354-1355. doi: 10.1136/gutjnl-2016-313455.
– reference: 28939662 - Gut. 2018 Jul;67(7):1365-1366. doi: 10.1136/gutjnl-2017-315067.
SSID ssj0008891
Score 2.595879
SecondaryResourceType review_article
Snippet ObjectiveThe benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic...
The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic review and...
Objective The benefits of pancreatic enzyme replacement therapy (PERT) in chronic pancreatitis (CP) are inadequately defined. We have undertaken a systematic...
SourceID pubmedcentral
proquest
pubmed
crossref
bmj
SourceType Open Access Repository
Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage 1354
SubjectTerms Abdomen
Alcohol
Clinical trials
Coatings
Cystic fibrosis
Diabetes
Dietary Fats - metabolism
Drug dosages
Enzyme Therapy
Enzymes
Enzymes - administration & dosage
Excretion
Exocrine Pancreatic Insufficiency - blood
Exocrine Pancreatic Insufficiency - drug therapy
Exocrine Pancreatic Insufficiency - etiology
Feces - chemistry
Health disparities
Humans
Long-term effects
Malnutrition
Meta-analysis
Nutritional Status
Osteoporosis
Pain
Pancreas
Pancreas - enzymology
Pancreatitis
Pancreatitis, Chronic - blood
Pancreatitis, Chronic - complications
Pancreatitis, Chronic - drug therapy
Quality of Life
Randomized Controlled Trials as Topic
Studies
Surgery
Title Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis
URI https://gut.bmj.com/content/66/8/1354.1.full
https://www.ncbi.nlm.nih.gov/pubmed/27941156
https://www.proquest.com/docview/1917815622
https://www.proquest.com/docview/1852666174
https://pubmed.ncbi.nlm.nih.gov/PMC5530474
Volume 66
WOSCitedRecordID wos000405191200018&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVPQU
  databaseName: Biological Science Database
  customDbUrl:
  eissn: 1468-3288
  dateEnd: 20250608
  omitProxy: false
  ssIdentifier: ssj0008891
  issn: 0017-5749
  databaseCode: M7P
  dateStart: 19600301
  isFulltext: true
  titleUrlDefault: http://search.proquest.com/biologicalscijournals
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Health & Medical Collection (ProQuest)
  customDbUrl:
  eissn: 1468-3288
  dateEnd: 20250608
  omitProxy: false
  ssIdentifier: ssj0008891
  issn: 0017-5749
  databaseCode: 7X7
  dateStart: 19600301
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/healthcomplete
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: ProQuest Central
  customDbUrl:
  eissn: 1468-3288
  dateEnd: 20250608
  omitProxy: false
  ssIdentifier: ssj0008891
  issn: 0017-5749
  databaseCode: BENPR
  dateStart: 19600301
  isFulltext: true
  titleUrlDefault: https://www.proquest.com/central
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Science Database (ProQuest)
  customDbUrl:
  eissn: 1468-3288
  dateEnd: 20250608
  omitProxy: false
  ssIdentifier: ssj0008891
  issn: 0017-5749
  databaseCode: M2P
  dateStart: 19600301
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/sciencejournals
  providerName: ProQuest
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1bixMxFD7YXRFfvOuOriWC-CLDTifJJPFFVLr4sqWIQt-GJJNZu2zT3XYq1F9vMslMrcIi-DIwJJkL37klOfkOwGsl6kIWBqe8GvGUYD1KufNTaUZzzTXVnlS9LTbBJhM-m4lpXHBbx7TKzia2hrpaar9GfuLnFZ7ZJM_fX12nvmqU312NJTQGcOhZEnCbujftLTHvKuY5S0wZEd2hGVycnG-aC3vpZGRUODOUUx9iDtTiYt89_RVz_pk6-ZsvOr3_v3_xAO7FKBR9CGLzEG4Z-wjunMV99sdgx55ZQuotWtbI2YsQWmpk7M_twqCVaVO5_MIiCge4tmhukQ5Eu7sBzXz9Du24olE4J4OkrdDCNDKVkRHlCXw7HX_99DmNlRlSRTFpUsorYrCocsx0wY1kOdbECEUUyypR1wVXmSRKuwalDM-4FFwRQ5QQhBlm8FM4sEtrjgBR5x-pUkQbIkjlunDJBZEG15lwz6YJvHGwlFeBe6Ns5yy4KAN-pcevDPglMOqQK3XkN_dlNi5vHPO2H_MvbzjuQC2jpq_LHaIJvOqbnY76jRdpzXLj-nDq4iAXK5IEngX56V-XO4PoovIiAbYnWX0Hz_-932Ln31secF_xiTDy_ObPegF3c68AbdLiMRw0q415Cbf1DycDqyEM2Iy1Vz6Ew4_jyfSLuzvLp8NWlX4B5ygkhA
linkProvider ProQuest
linkToHtml http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V3JbhQxEC0lAQEXdkJDACMBF9RKj5duGwkhBIkSJRnlEKTcGtvtJhNlPGEW0PBRfCPl3oYBKeKSA2dvvTw_l-2qVwAvjCpTnToWy6InY85sL5a4TsWJoFZaYYOoepVsIuv35fGxOlyBn20sTHCrbDmxIupiZMMZ-WbYVwRlE0rfnX-NQ9aocLvaptCoYbHn5t9xyzZ5u_sR_-9LSre3jj7sxE1WgdgIxqexkAV3TBWUZTaVTmeUWe6U4SZLClWWqTSJ5sZigTFOJlIrabjjRimeucwx7HcVrqAZQWXlKnjYMb9sM_Qh84uMqzZIh6WbX2bTU3-GmOylSHtUBJN21QxPl5fDv2zcP101f1v7tm_9b1_tNtxsrGzyvp4Wd2DF-btw7aDxI7gHfisoZ2g7J6OSIB_WprMlzv-YDx0Zu8pVLRyckjpAbU4GnthaSHjRYDqYvCELLWxSxwER7QsydFMd60bx5T58upS3fQBrfuTdQyAC139hDLeOK15gFaml4tqxMlHYt4jgFcIgP6-1RfJqT8bSvMZLHvCS13iJoNciJbeNfntII3J2YZvXXZt_GWGjBVHeMNkkXyAoguddMXJQuFjS3o1mWEcKtPPQFuYRrNd47YajSPi460gjyJaQ3FUI-ubLJX5wUumch4xWPOOPLn6sZ3B95-hgP9_f7e89hhs0TL7KQXMD1qbjmXsCV-03xMP4aTVZCXy-bJz_AntIftU
linkToPdf http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1bb9MwFD7aBpp44T4IDDAS8IKipokT25MQQmwV06DqA0h7C7bjQKfVHW0KKj-NX7fjOEkpSBMve-DZt1w-n4t9zncAnilRZjIzSciLPg9povshRz0VRmmsuU61I1Wvi02w4ZAfH4vRBvxqc2FcWGUrE2tBXUy1OyPvOb_CMZvEca9swiJG-4PXZ99CV0HK3bS25TQ8RI7M8ge6b_NXh_v4r5_H8eDg49t3YVNhIFRpQqsw5QU1iSjihOmMG8niRFMjFFUsKkRZZlxFkiqNDUoZHnEpuKKGKiEoM8wkOO8mXGGOtLwOGxx1WoC31fpQC6SMijZhJ8l6XxbViT1FfPYzFIFx6szbTTU5WVeNf9m7f4Zt_qYHBzf-5y94E6431jd547fLLdgw9jZsf2jiC-6APXCMGlIvybQkKCe9Sa2JsT-XE0Nmpg5hcweqxCeuLcnYEu0JhlcDqvF8j6w4sonPDyLSFmRiKhnKhgnmLny6lLfdgS07teY-kBTtglQpqg0VtMAuXHJBpUnKSODcaQAvEBL5meccyWtfLclyj53cYSf32Amg36Im1w2vuysvcnrhmJfdmH9ZYbcFVN5IuHm-QlMAT7tmlE3uwklaM11gH56i_Yc2Mg3gnsdut1yMigC9kSwAtobqroPjPV9vseOvNf-5q3RFGX1w8WM9gW2Ed_7-cHj0EK7Fbh_WcZu7sFXNFuYRXNXfEQ6zx_W-JfD5smF-DouJh5I
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Efficacy+of+pancreatic+enzyme+replacement+therapy+in+chronic+pancreatitis%3A+systematic+review+and+meta-analysis&rft.jtitle=Gut&rft.au=de+la+Iglesia-Garc%C3%ADa%2C+Daniel&rft.au=Huang%2C+Wei&rft.au=Szatmary%2C+Peter&rft.au=Baston-Rey%2C+Iria&rft.date=2017-08-01&rft.eissn=1468-3288&rft.volume=66&rft.issue=8&rft.spage=1354&rft_id=info:doi/10.1136%2Fgutjnl-2016-312529&rft_id=info%3Apmid%2F27941156&rft.externalDocID=27941156
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0017-5749&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0017-5749&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0017-5749&client=summon