Original articleClinical endoscopyA prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis
Section snippets
Study population
The institutional review board at the Cleveland Clinic approved this research protocol. Patients with pancreatic-type abdominal pain13 with suspected or established chronic pancreatitis who were capable of informed consent were prospectively recruited. A focused medical history and physical examination was obtained from every subject. Female subjects of childbearing potential underwent a urine pregnancy test before each study procedure. All patients had recent cross-sectional imaging (CT/MRCP)
Demographic characteristics
Twenty-eight patients evaluated for chronic pancreatitis were recruited between January 2003 and December 2005 (Table 1). Four patients would not tolerate placement of the Dreiling tube, leaving 24 patients for analysis. Three patients had to repeat the Dreiling PFT because gastric fluid contamination was suspected on the basis of very low bicarbonate concentrations in all samples (<10 mEq/L). None of the ePFT tests had to be repeated for suspected gastric fluid contamination.
Bicarbonate results
In traditional
Discussion
We have shown that the endoscopic and Dreiling methods for secretin PFT produce similar bicarbonate results in patients evaluated for chronic pancreatitis. No significant differences were found between the two methods in either peak bicarbonate concentration or estimated bicarbonate output. These results suggest that the 1-hour endoscopic collection of secretin-stimulated duodenal fluid accurately measures exocrine function in the evaluation of patients with pancreatic-type abdominal pain.
After
References (32)
- et al.
Diagnosis of chronic pancreatitis
Gastroenterology
(1985) - et al.
Exocrine pancreatic insufficiency in celiac sprue: a cause of treatment failure
Gastroenterology
(1980) - et al.
An endoscopic pancreatic function test with synthetic porcine secretin test for the evaluation of chronic abdominal pain and suspected chronic pancreatitis
Gastrointest Endosc
(2003) - et al.
An endoscopic pancreatic function test with cholecystokinin-octapeptide for the diagnosis of chronic pancreatitis
Clin Gastroenterol Hepatol
(2003) - et al.
Electrolyte composition of endoscopically collected duodenal drainage fluid after synthetic porcine secretin stimulation in healthy subjects
Gastrointest Endosc
(2004) - et al.
Sedation for colonoscopy using a single bolus is safe, effective and efficient: a prospective, randomized, double blind trial
Am J Gastroenterol
(2000) - et al.
Human secretin: biologic effects and plasma kinetics in humans
Gastroenterology
(1988) - et al.
Diagnosis of chronic pancreatitis: is a gold standard necessary?
Surg Clin North Am
(1999) - et al.
Do cytokine concentrations in pancreatic juice predict the presence of pancreatic diseases?
Clin Gastroenterol Hepatol
(2006) - et al.
Evaluating exocrine function tests for diagnosing chronic pancreatitis
Pancreas
(1997)
A prospective comparison of current diagnostic tests in pancreatic cancer
N Engl J Med
Studies in pancreatic function: preliminary series of clinical studies with the secretin test
Gastroenterology
The effect of moderate sedation on exocrine pancreas function in normal healthy subjects: a prospective, randomized, cross-over trial using the synthetic porcine secretin stimulated endoscopic pancreatic function test
Am J Gastroenterol
Review article: exocrine function testing
Aliment Pharmacol Ther
Diagnosis of chronic pancreatitis and exocrine insufficiency
Hosp Pract
A randomized crossover study of secretin-stimulated endoscopic and Dreiling-tube pancreatic function test methods in healthy subjects
Am J Gastroenterol
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