Exocrine Pancreatic Function Measured with Ultrasonography and Endoscopic Short Tests

Secretin stimulated ultrasonography can assess pancreatic fluid flow and can combine with endoscopic short tests to evaluate exocrine pancreatic function, according to research published in the Scandinavian Journal of Gastroenterology.

Researchers from Haukeland University Hopsital in Bergen, Norway included chronic pancreatitis (CP), cystic fibrosis (CF), and healthy participants in their study design. The authors noted that volume output failure is a feature of decreasing exocrine pancreatic function and can be assessed by secretin stimulated MRI. Several studies have demonstrated this, but this study aimed to evaluate ultrasonography of the fluid in the descending duodenum and Wirsung duct (WD) after secretin stimulation as a measure of pancreatic fluid flow in patients expected to have severe output failure.

The participants were classified into groups based on exocrine pancreatic function. The patients underwent trans abdominal ultrasonography before, during, and 15 minutes after secretin intravenous duodenal juice was collected by endoscopic short test. Bicarbonate concentration was also measured.

The researchers found insufficient CF patients and CP insufficient patients showed less duodenal fluid filling compared to other groups. Measuring the WD diameter was able to identify the most severe failure in the insufficient CF group, but not other groups.

“Secretin stimulated ultrasonography can be used to assess pancreatic fluid flow and may be combined with endoscopic short test in the evaluation of exocrine pancreatic function,” the authors concluded. “Fluid filling in the descending part of duodenum was the most accurate predictor of pancreatic insufficiency in both patient groups. The test demonstrated better diagnostic accuracy diagnosing exocrine pancreatic failure in the cystic fibrosis patients than in chronic pancreatitis patients.”