NDLI: Update on endoscopic pancreatic function testing

Content Provider	PubMed Central
Author	Stevens, Tyler Parsi, Mansour A.
Copyright Year	2011
Abstract	Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the “Dreiling tube” secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis. This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditional fluid analysis.
Related Links	http://dx.doi.org/10.3748/wjg.v17.i35.3957
Starting Page	3957
File Format	PDF
ISSN	10079327
Journal	World Journal of Gastroenterology : WJG
Issue Number	35
Volume Number	17
Language	English
Publisher	Baishideng Publishing Group Co., Limited
Publisher Date	2011-01-01
Access Restriction	Open
Rights Holder	Baishideng Publishing Group Co., Limited
Subject Keyword	Gastroenterology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Gastroenterology

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