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Background:Determination of fecal elastase-1 is well established in the diagnosis of exocrine pancreatic insufficiency (EPI). However, accelerated gastro-intestinal passage could result in false positive results. Serum-beta-Carotin is an indirect parameter to measure the malassimilation of lipids, but is not determined in the diagnostic of EPI yet. Aim of the study was to evaluate the validity of Serum-beta-Carotin in the EPI-diagnostic pre- and postoperatively. Methods:All patients underwent pancreatic surgery were prospectively collected from Jan.2009-Sept. 2009. Fecal Elastase-1, serum-beta-Carotin and clinical features were analyzed preoperatively and 1 week, 3 and 6 month postoperatively together with surgical procedure and diagnosis. Ergebnisse:During the observation period 125 patients underwent pancreatic surgery. The results of preoperative fecal elastase-1 and serum-beta-Carotin showed significant lower values in pat. with chronic pancreatitis (CP) in contrast to pat. with benign and malign tumors (p≤0.005; Anova). One week postoperatively, serum-beta-Carotin was significantly decreased in pat. after pancreatic head resection (PHR) in contrast to pat. after left pancreatic resection (LPR) or bypass-procedures (BP) (p≤0.05; Anova). In contrast, one week postoperatively fecal elastase-1 was decreased in all groups regardless of the surgical procedure without any differences in the clinical features. The follow-up revealed reduced values for both parameters in pat. with PHR compared to pat. with LPR or BP. Overall, postoperative serum-beta-Carotin was more frequently in normal range than the values of fecal elastase-1 in patients without clinical signs of exocrine insufficiency. Conclusion:Our data demonstrate that serum-beta-Carotin is equivalent with fecal elastase-1 in the diagnosis of exocrine pancreatic insufficiency following pancreatic surgery. Moreover, the validity of serum-beta-Carotin seems to be superior to fecal Elastase-1.