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Fig 1.

Flowchart of the retrospective study from a database for chronic pancreatitis.

Short EST = Short endoscopic secretin test. The Layer score bases on imaging, pancreas function testing and clinical history. Similar to the Mayo score it differentiates between CP (chronic pancreatitis) and non-CP (= result of scoring not suggestive for chronic pancreatitis). PEI = pancreatic exocrine insufficiency. We defined gold standard for PEI as Bicarbonate concentration < 80 mmol/l in the short endoscopic secretin test as it is a direct pancreas function test. Consecutively a test result of bicarbonate concentration in duodenal juice > 80 mmol/l is not suggestive for pancreatic exocrine insufficiency (non-PEI). HC = healthy controls.

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Table 1.

Demographic data and results from pancreatic function testing.

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Table 2.

Nutrition intake.

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Fig 2.

Correlation of fecal fat (g/d) vs fat absorption (%) in relation to fat intake (g/d).

All study subjects.

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Fig 3.

Correlation of fecal fat (g/d) vs fat absorption (%) in relation to fat intake (g/d).

Recommended range of fat intake (80–120 g/d). Absolute fat values in stool correlate well to the more complex, intake adjusted fat absorption coefficient.

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Fig 4.

ROC curves for EPI parameters in all study subjects.

As result of direct pancreas testing bicarbonate in duodenal juice after secretin stimulation was chosen as standard. No significant difference in Area under the curve (AUC) between f-Elastase and fecal fat (CI -0,15 to 0,25); f-Elastase and CFA (CI -0,19 to 0,25); fecal fat and CFA (-0,11 to 0,08) ROC curve = receiver operating characteristic curve; AUC = Area under the curve; CI = confidence interval.

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Table 3.

Accuracy for indirect exocrine pancreas function parameters against exocrine pancreatic function determined by endoscopic secretin test.

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Fig 5.

Daily fat output (fecal fat g/d) in median and interquartile range.

Cut off after definition in the literature 7 gram per day (dashed line). Significant difference between HC/ CP and non-CP/CP. CP patients have pathologic daily fat output.

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Fig 6.

Coefficient of fat absorption.

Generally accepted cut off is 90% (dashed line). Reciprocal results as in “A” indicate no additional information of fat absorption. CP patients have significant lower fat absorption than healthy controls and non-CP patients. HC: healthy controls; CP: chronic pancreatitis; non-CP: patients not scoring for chronic pancreatitis.

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