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Pancreas ; 46(6): 770-775, 2017 07.
Article in English | MEDLINE | ID: mdl-28609365

ABSTRACT

OBJECTIVE: We aimed to determine the feasibility and accuracy of a combined endoscopic ultrasonography (EUS) with a shortened pancreatic function testing (sEUS) for structural and functional assessment using a single instrument in patients with suspected chronic pancreatitis (CP). METHODS: We completed a prospective crossover study, enrolling patients with suspected CP. Patients who underwent both traditional 1-hour secretin pancreatic function test (sPFT) and sEUS were included in the analysis. We compared study results for test concordance and for correlation of peak bicarbonate concentrations. RESULTS: Eleven (64.7%) of 17 patients had concordant sPFT and sEUS findings when the cutoff for peak bicarbonate was 80 mEq/L. Six patients had discordant findings with a negative sPFT and positive sEUS. This poor concordance suggests that sEUS is an unreliable functional test. Lowering the sEUS cutoff to 70 mEq/L resulted in improved concordance (64.7% vs 70.6%). Finally, there was no significant correlation between peak bicarbonate concentrations (r = 0.47; 95% confidence interval, -0.02 to 0.79) in these 2 functional tests. CONCLUSIONS: We demonstrate poor concordance between sPFT and sEUS suggesting that a combined shortened functional and structural test using a single instrument may not be a feasible test for diagnosis of suspected CP when a cutoff of 80 mEq/L is used.


Subject(s)
Endoscopy, Gastrointestinal , Endosonography , Pancreatic Function Tests , Pancreatic Juice/metabolism , Pancreatitis, Chronic/diagnostic imaging , Pancreatitis, Chronic/metabolism , Secretin/metabolism , Adult , Biomarkers/metabolism , Cross-Over Studies , Endoscopes, Gastrointestinal , Endoscopy, Gastrointestinal/instrumentation , Endosonography/instrumentation , Feasibility Studies , Female , Humans , Male , Middle Aged , Pancreatic Function Tests/instrumentation , Pancreatitis, Chronic/physiopathology , Predictive Value of Tests , Prognosis , Prospective Studies , Reproducibility of Results , Time Factors , Workflow
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