Pancreatic duct compliance after secretin stimulation: a novel endoscopic ultrasound diagnostic tool for chronic pancreatitis

Pancreas. 2012 Mar;41(2):290-4. doi: 10.1097/MPA.0b013e318229db6b.

Abstract

Objectives: Endoscopic ultrasound (EUS) evaluation of pancreatic duct compliance after secretin stimulation (sEUS) along with EUS morphologic examination (EUS) and duodenal fluid [HCO3] measurement (endoscopic pancreatic function test, ePFT) in 1 endoscopic session has not been reported as a means of evaluating for chronic pancreatitis (CP). We evaluated the feasibility of the combined examination and compared EUS measurements of pancreatic ductal compliance with duodenal fluid [HCO3] for diagnosing CP.

Methods: The study is a prospective case series of patients with suspected CP who underwent a combined EUS, sEUS, and ePFT examination in 1 endoscopic session. The main outcome measures were the feasibility of performing the combination examination and the correlation between ductal compliance and ePFT.

Results: All examinations were completed in 1 endoscopic session, and there were no complications in 35 patients. Although there was a trend toward less change from baseline head and body ductal diameter in patients with CP, only the percent change from baseline in the tail was significant (CP 144.3% vs healthy patients 240.9%, P < 0.01). Regression analysis demonstrated fair correlation between maximum change in ductal diameter and duodenal fluid [HCO3] (r = 0.27).

Conclusions: Combined EUS, sEUS, and ePFTs are feasible and safe, with preliminary results demonstrating a positive correlation between pancreatic ductal compliance and duodenal fluid [HCO3].

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bicarbonates / metabolism
  • Chi-Square Distribution
  • Compliance
  • Duodenum / metabolism
  • Endosonography*
  • Feasibility Studies
  • Female
  • Humans
  • Intestinal Secretions / metabolism
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • New Hampshire
  • Pancreatic Ducts / diagnostic imaging*
  • Pancreatic Ducts / physiopathology
  • Pancreatic Function Tests*
  • Pancreatitis, Chronic / diagnostic imaging*
  • Pancreatitis, Chronic / metabolism
  • Pancreatitis, Chronic / physiopathology
  • Predictive Value of Tests
  • Prospective Studies
  • Secretin*

Substances

  • Bicarbonates
  • Secretin