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

Pancreas. 2017 Jul;46(6):770-775. doi: 10.1097/MPA.0000000000000829.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers / metabolism
  • Cross-Over Studies
  • Endoscopes, Gastrointestinal
  • Endoscopy, Gastrointestinal* / instrumentation
  • Endosonography* / instrumentation
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Function Tests* / instrumentation
  • Pancreatic Juice / metabolism*
  • Pancreatitis, Chronic / diagnostic imaging*
  • Pancreatitis, Chronic / metabolism*
  • Pancreatitis, Chronic / physiopathology
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Secretin / metabolism*
  • Time Factors
  • Workflow

Substances

  • Biomarkers
  • Secretin