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A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing
Tyler Stevens1, Darwin L Conwell, Gregory Zuccaro
1Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Background:
Direct pancreatic function tests (PFT) are conventionally performed with use of double-lumen "Dreiling" collection tubes. We have developed an endoscopic collection method (ePFT) that eases the performance of these tests.
Objective:
Our aim was to compare the bicarbonate results obtained from the secretin ePFT and Dreiling PFT methods in patients evaluated for chronic pancreatitis.
Design:
A prospective crossover design was used to compare the PFT methods.
Setting:
Tertiary care referral center.
Patients And Interventions:
Twenty-four patients undergoing an evaluation for chronic pancreatitis underwent the secretin-stimulated ePFT and Dreiling PFT methods on separate days.
Main Outcome Measurements:
Duodenal fluid bicarbonate concentrations and estimated bicarbonate outputs were compared.
Results:
The mean difference in peak bicarbonate concentration (Dreiling PFT minus ePFT) was 7 mEq/L (SD 20) and not statistically significant (P = .11). A good correlation in peak bicarbonate concentrations (r = 0.74, 95% CI, 0.48-0.88) and estimated bicarbonate output (r = 0.78, 95% CI, 0.54-0.90) was observed between the two PFT methods.
Limitation:
The sensitivities and specificities of the secretin ePFT and Dreiling PFT could not be compared because of the lack of a histologic gold standard.
Conclusion:
The secretin ePFT yields results similar to those of the Dreiling PFT in patients evaluated for chronic pancreatitis.
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