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Relation entre la morphologie canalaire et la fonction exocrine du pancréas: une méthode originate d’estimation linéaire de la fonction pancréatique

A study of the relationship between the canalar morphology and the exocrine function of the pancreas. A new method of linear estimation of the pancreatic function

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Acta Endoscopica

Résumé

Les résultats du tubage duodénal et du tubage pancréatique sélectif ont été comparés à la morphologie canalaire pancréatique obtenue par cholangiopancréatographie endoscopique chez des sujets normaux et des patients porteurs de pancréatite chronique. Le diagnostic de pancréatite chronique repose sur des bases clinico-morphologiques et les patients sont répartis du point de vue morphologique en groupes de sévérité croissante classés de 1 à 4.

Les volumes sécrétaires, les concentrations et débits de bicarbonate et d’amylase après stimulation par sécrétine ou caeruléine ont été mesurés.

Une analyse discriminate a permis de pondérer et de combiner linéairement les paramètres utiles à déterminer. En ce qui concerne le tubage pancréatique sélectif, l’association du débit maximum en bicarbonate/minute et de la concentration maximale en bicarbonate après sécrétine est la plus discriminante et permet de classer correctement 70 % des patients dans leur ≪ groupe morphologique ≫ respectif. Quant au tubage duodenal, l’association de la concentration maximale en bicarbonate du débit maximal d’amylase sous caeruléine et lors du washing-out permet une classification correcte dans 46 % des cas.

Cette analyse mathématique appliquée aux résultats du tubage pancréatique sélectif a l’originalité d’évaluer de manière linéaire la fonction pancréatique exocrine et fournit par le seul dosage de l’ionogramme pancréatique une aide précieuse complémentaire à la pancréatographie dans le diagnostic des pancréatites chroniques.

Summary

The exocrine function of the pancreas studied through the duodenal drainage (DD) and through the pure pancreatic juice collection (PPJ) has been correlated with the duct’s morphology obtained via endoscopic pancreatography for patients with chronic pancreatitis.

The diagnosis of chronic pancreatitis was assessed on clinical and radiological grounds and the patients were classified in 4 grades of severity related to the abnormalities of the pancreatography.

The volume of the secretion and the concentrations and outputs of bicarbonate and amylase after secretin-pancreozymin stimulation have been recorded.

A discriminant analysis permitted to ponder and to combine on a linear way the useful parameters.

For the DD, the maximal bicarbonate concentration combined with the maximal amylase output allows a correct classification for only 46 % of the patients.

On the other hand, the maximum bicarbonate output and the maximum bicarbonate concentration in the PPJ after secretin is the most discriminant combination, providing the best (70 %) correspondance to the morphologic classification.

This mathematical analysis of the PPJ electrolytes has the advantage to provide a linear evaluation of the pancreatic exocrine function, which is complementary to the pancreatography in the diagnosis of chronic pancreatitis.

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Authors and Affiliations

  1. Service de Gastroentérologie, U.L.B., Hôpital Erasme, Bruxelles, Belgique

    J. Devière, M. Delhaye & M. Cremer

  2. Service de Biologie Clinique, U.L.B., Hôpital Erasme, Bruxelles, Belgique

    B. Gulbis & M. Quenon

Authors
  1. J. Devière
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  2. B. Gulbis
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  3. M. Delhaye
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  4. M. Quenon
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  5. M. Cremer
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Tirés à part: Dr J. Devière, Service de Gastroentérologie, Hôpital Erasme, Route de Lennik 808, 1070 Bruxelles (Belgique).

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Devière, J., Gulbis, B., Delhaye, M. et al. Relation entre la morphologie canalaire et la fonction exocrine du pancréas: une méthode originate d’estimation linéaire de la fonction pancréatique. Acta Endosc 15, 403–414 (1985). https://doi.org/10.1007/BF02966210

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  • DOI: https://doi.org/10.1007/BF02966210

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