A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis

BackgroundDirect 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.ObjectiveOur aim was to compare the bicarbonate results obtained from the secretin ePFT and Dreiling PFT methods in patients evaluated for chronic pancreatitis.DesignA prospective crossover design was used to compare the PFT methods.SettingTertiary care referral center.Patients and InterventionsTwenty-four patients undergoing an evaluation for chronic pancreatitis underwent the secretin-stimulated ePFT and Dreiling PFT methods on separate days.Main Outcome MeasurementsDuodenal fluid bicarbonate concentrations and estimated bicarbonate outputs were compared.ResultsThe 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.LimitationThe sensitivities and specificities of the secretin ePFT and Dreiling PFT could not be compared because of the lack of a histologic gold standard.ConclusionThe secretin ePFT yields results similar to those of the Dreiling PFT in patients evaluated for chronic pancreatitis.