| Endoscopic pancreatic function test using combined secretin and cholecystokinin stimulation for the evaluation of chronic pancreatitis. | |
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MedLine Citation:
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PMID: 22281107 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Current endoscopic pancreatic function test (ePFT) methods use either secretin or cholecystokinin (CCK) to measure pancreatic function. OBJECTIVE: To evaluate a novel ePFT protocol that includes both secretin and CCK stimulation and to assess which fluid parameters best discriminate patients with chronic pancreatitis (CP). DESIGN: Prospective, cross-sectional diagnostic study. SETTING: Single, tertiary-care institution. PATIENTS: Healthy volunteers and patients evaluated for CP were included. INTERVENTIONS: All patients underwent a combined secretin-CCK ePFT. Patients evaluated for CP also underwent EUS during the same endoscopic session. MAIN OUTCOME MEASUREMENTS: Duodenal fluid bicarbonate, lipase, and amylase concentrations were measured after CCK and secretin stimulation. Results were compared based on the presence of CP detected by EUS (≥5 features). RESULTS: Twenty healthy volunteers and 69 patients evaluated for CP completed the secretin and CCK ePFT. Patients with an EUS score of 5 or higher had significantly decreased peak bicarbonate concentrations (72 mmol) compared with patients with an EUS score lower than 5 (90 mmol) and healthy subjects (108 mmol) (P < .001). Peak concentrations of amylase and lipase and total fluid volume were not significantly different between patients with CP and controls. Receiver-operating characteristic analysis revealed that peak bicarbonate concentration had superior discrimination for CP (area under the curve [AUC] 0.738) compared with peak amylase (AUC 0.677) and peak lipase (AUC 0.627). The addition of enzyme concentration measurement did not improve discrimination compared with peak bicarbonate alone. LIMITATIONS: Secretin and cholecystokinin endoscopic pancreatic function test (SC ePFT) results were not compared with those of single hormone ePFTs. CONCLUSIONS: The addition of CCK infusion and enzyme concentration measurement to a standard secretin ePFT does not enhance the diagnosis of CP. |
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Authors:
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Ryan Law; Rocio Lopez; Adele Costanzo; Mansour A Parsi; Tyler Stevens |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-24 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: - ISSN: 1097-6779 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Medicine Institute, The Cleveland Clinic, Cleveland, Ohio, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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