A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis

Gastrointest Endosc. 2008 Mar;67(3):458-66. doi: 10.1016/j.gie.2007.07.028.

Abstract

Background: Direct pancreatic function tests (PFT) are conventionally performed with use of double-lumen "Dreiling" collection tubes. We have developed an endoscopic collection method (ePFT) that eases the performance of these tests.

Objective: Our aim was to compare the bicarbonate results obtained from the secretin ePFT and Dreiling PFT methods in patients evaluated for chronic pancreatitis.

Design: A prospective crossover design was used to compare the PFT methods.

Setting: Tertiary care referral center.

Patients and interventions: Twenty-four patients undergoing an evaluation for chronic pancreatitis underwent the secretin-stimulated ePFT and Dreiling PFT methods on separate days.

Main outcome measurements: Duodenal fluid bicarbonate concentrations and estimated bicarbonate outputs were compared.

Results: The mean difference in peak bicarbonate concentration (Dreiling PFT minus ePFT) was 7 mEq/L (SD 20) and not statistically significant (P = .11). A good correlation in peak bicarbonate concentrations (r = 0.74, 95% CI, 0.48-0.88) and estimated bicarbonate output (r = 0.78, 95% CI, 0.54-0.90) was observed between the two PFT methods.

Limitation: The sensitivities and specificities of the secretin ePFT and Dreiling PFT could not be compared because of the lack of a histologic gold standard.

Conclusion: The secretin ePFT yields results similar to those of the Dreiling PFT in patients evaluated for chronic pancreatitis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bicarbonates / metabolism
  • Cross-Over Studies
  • Duodenum / metabolism
  • Endoscopy, Gastrointestinal*
  • Female
  • Gastrointestinal Agents
  • Humans
  • Intestinal Secretions / metabolism
  • Intubation, Gastrointestinal*
  • Male
  • Middle Aged
  • Pancreatic Function Tests / methods*
  • Pancreatitis, Chronic / diagnosis*
  • Pancreatitis, Chronic / metabolism
  • Prospective Studies
  • Secretin
  • Sensitivity and Specificity
  • Specimen Handling / methods*

Substances

  • Bicarbonates
  • Gastrointestinal Agents
  • Secretin