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Published on: July 30, 2011
Exocrine pancreatic function after gastrectomy. Specificity of indirect tests
G Heptner1, S Domschke, W Domschke
1Department of Medicine, University of Erlangen-Nuremberg, Federal Republic of Germany.
Gastroenterology
|July 1, 1989
Summary
Pancreatic function tests show reduced specificity after gastrectomy. Only the plasma amino acid consumption test remains accurate post-surgery, unaffected by anatomical changes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Diagnostic Medicine
Background:
- Pancreatic function tests are crucial for assessing exocrine pancreatic function.
- Gastric surgery, including total (Roux-en-Y) and subtotal (Billroth II) gastrectomy, can alter gastrointestinal anatomy.
- The impact of these anatomical changes on the specificity of indirect pancreatic function tests is not fully understood.
Purpose of the Study:
- To compare the intraindividual specificity of indirect pancreatic function tests before and after gastrectomy.
- To evaluate the effect of total versus subtotal gastrectomy on test specificity.
- To identify pancreatic function tests that maintain accuracy after gastric surgery.
Main Methods:
- Intraindividual comparison of pancreatic function test specificity in patients undergoing gastrectomy.
- Tests evaluated: pancreolauryl test, bentiromide test, fecal chymotrypsin, and plasma amino acid consumption test.
- Patients included: 4 undergoing total gastrectomy (Roux-en-Y) and 6 undergoing subtotal gastrectomy (Billroth II).
Main Results:
- Pre-gastrectomy, most tests showed 100% specificity, except pancreolauryl test (90%).
- Post-gastrectomy specificities: pancreolauryl test (10%), bentiromide test (70%), fecal chymotrypsin (70%), plasma amino acid consumption test (100%).
- Significant reductions in specificity were observed for pancreolauryl, bentiromide, and fecal chymotrypsin tests; plasma amino acid consumption test specificity remained unaffected.
Conclusions:
- Post-gastric surgery, indirect pancreatic function tests exhibit variable specificity.
- The plasma amino acid consumption test is the only reliable indirect pancreatic function test after gastrectomy.
- Anatomical alterations following gastrectomy do not impact the specificity of the plasma amino acid consumption test.
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