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

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.