Comparison of Combined Endoscopic Ultrasonography and Endoscopic Secretin Testing With the Traditional Secretin Pancreatic Function Test in Patients With Suspected Chronic Pancreatitis: A Prospective Crossover Study. Issue 6 (July 2017)

• Record Type: Journal Article
• Authors: Kothari, Darshan; Ketwaroo, Gyanprakash; Sawhney, Mandeep S.; Freedman, Steven D.; Sheth, Sunil G.
• Is Part Of: Pancreas. Volume 46:Issue 6(2017)
• Publication Date: 2017-07
• Subjects: chronic pancreatitis -- pancreatic function testing -- endoscopic ultrasound; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000000829
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objective: We aimed to determine the feasibility and accuracy of a combined endoscopic ultrasonography (EUS) with a shortened pancreatic function testing (sEUS) for structural and functional assessment using a single instrument in patients with suspected chronic pancreatitis (CP). Methods: We completed a prospective crossover study, enrolling patients with suspected CP. Patients who underwent both traditional 1-hour secretin pancreatic function test (sPFT) and sEUS were included in the analysis. We compared study results for test concordance and for correlation of peak bicarbonate concentrations. Results: Eleven (64.7%) of 17 patients had concordant sPFT and sEUS findings when the cutoff for peak bicarbonate was 80 mEq/L. Six patients had discordant findings with a negative sPFT and positive sEUS. This poor concordance suggests that sEUS is an unreliable functional test. Lowering the sEUS cutoff to 70 mEq/L resulted in improved concordance (64.7% vs 70.6%). Finally, there was no significant correlation between peak bicarbonate concentrations ( r = 0.47; 95% confidence interval, −0.02 to 0.79) in these 2 functional tests. Conclusions: We demonstrate poor concordance between sPFT and sEUS suggesting that a combined shortened functional and structural test using a single instrument may not be a feasible test for diagnosis of suspected CP when a cutoff of 80 mEq/L is used.