Evaluation of pancreatic exocrine secretion using 13C-dipeptide (benzoyl-L-tyrosyl-[1-(13)C]alanine) breath test: focusing on pancreatoduodenectomy cases.
OBJECTIVE
We investigated whether a breath test using benzoyl-L-tyrosyl-[1-(13)C]alanine (Bz-Tyr-Ala) allows assessment of pancreatic exocrine function.


METHODS
Benzoyl-L-tyrosyl-[1-(13)C]alanine was orally administered, and changes in (13)CO2 were expressed as delta per thousand. The breath test was performed in chronic pancreatitis patients and healthy subjects in a preliminary study and, subsequently, in 17 pancreatoduodenectomy patients, to examine the difference between the results obtained at the times of pancreatic tube insertion and removal, the relationship between breath test results after tube removal and the volume of pancreatic juice drained, and the difference in results between the presence versus the absence of histological changes of chronic pancreatitis.


RESULTS
The delta per thousand was lower in the chronic pancreatitis patients than in healthy subjects. In the postoperative patients, the delta per thousand was higher at tube insertion than at tube removal. The correlations of the delta per thousand with the maximum volume of pancreatic juice, its mean volume, and pancreatic juice amylase levels were 0.865, 0.757, and 0.853, respectively. The delta per thousand was lower in 11 patients with that in 6 patients without histological changes of chronic pancreatitis.


CONCLUSIONS
These results suggest that the Bz-Tyr-Ala breath test can measure pancreatic exocrine function.
Ishii
Yukimoto
Y
Department of Digestive Surgery, Division of Genetic and Genomic Research, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan. yishii@med.nihon-u.ac.jp
Kohno
Tadashi
T
Ito
Asuka
A
Suzuki
Shigeru
S
Kohno
Tomohisa
T
Takayama
Tadatoshi
T
Asai
Satoshi
S
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000681:Amylases / Q000378:metabolism; D001944:Breath Tests; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D002268:Carboxypeptidases / Q000378:metabolism; D016022:Case-Control Studies; D004151:Dipeptides / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D010186:Pancreatic Function Tests / Q000379:methods*; D010189:Pancreatic Juice / Q000201:enzymology / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome
D002247:Carbon Isotopes; D004151:Dipeptides; C526135:benzoyl-tyrosyl-alanine; D002245:Carbon Dioxide; D000681:Amylases; D002268:Carboxypeptidases