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Digestive Diseases and Sciences

, Volume 55, Issue 9, pp 2681–2687 | Cite as

Combined Endoscopic Ultrasound and Secretin Endoscopic Pancreatic Function Test in Patients Evaluated for Chronic Pancreatitis

  • Tyler StevensEmail author
  • John A. Dumot
  • Mansour A. Parsi
  • Gregory Zuccaro
  • John J. Vargo
Original Article

Abstract

Background

Endoscopic ultrasound and endoscopic secretin pancreatic function test may be combined in a single endoscopic session (EUS/ePFT) to diagnose chronic pancreatitis (CP).

Aims

Our primary aim was to assess the correlation and concordance of combined EUS and secretin ePFT bicarbonate results in suspected minimal change CP.

Methods

Radial EUS included scoring for nine criteria (normal <4 criteria) with endoscopic collection of duodenal samples at 15, 30, and 45 min after secretin stimulation (normal peak bicarbonate ≥80 mmol/l).

Results

Three hundred and two patients completed the EUS/ePFT (252 for suspected minimal change CP, 38 for established CP, 12 for painless steatorrhea). In patients evaluated for suspected minimal change CP, a moderate negative correlation was observed between endoscopic ultrasound score and peak bicarbonate (r = −0.38, P < 0.001). The EUS and ePFT results were 76% concordant and 24% discordant. The ePFT was 85% sensitive and EUS was 100% sensitive for detecting patients with established calcific CP. The EUS/ePFT diagnosed CP in two of 12 of patients evaluated for painless steatorrhea or diarrhea with weight loss.

Conclusions

The combined EUS/ePFT is feasible and safe. There is only moderate correlation and concordance of endoscopic ultrasound and endoscopic pancreatic function test results in patients with suspected minimal change CP. The EUS and ePFT results produce complimentary functional and structural information for the evaluation of CP.

Keywords

Chronic pancreatitis Pancreatic function testing Endoscopic ultrasound 

Abbreviations

CI

Confidence interval

CP

Chronic pancreatitis

CT

Computed tomography

EUS

Endoscopic ultrasound

ePFT

Endoscopic pancreatic function test

mmol/l

Millimoles per liter

NPV

Negative predictive value

PFT

Pancreatic function test

PPV

Positive predictive value

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Tyler Stevens
    • 1
    Email author
  • John A. Dumot
    • 1
  • Mansour A. Parsi
    • 1
  • Gregory Zuccaro
    • 1
  • John J. Vargo
    • 1
  1. 1.Digestive Disease InstituteThe Cleveland Clinic FoundationClevelandUSA

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