title: Usefulness of a 13C-labeled mixed triglyceride breath test for assessing pancreatic exocrine function after pancreatic surgery.
abstract: BACKGROUND
  Although the fecal elastase-1 test is a satisfactory pancreatic exocrine function test, breath tests that use stable isotopes have been developed recently as alternatives. We evaluated the usefulness of a (13)C-labeled mixed triglyceride breath test for assessing pancreatic exocrine function after pancreatic surgery.
  
  
  METHODS
  The breath test and the fecal elastase-1 test were performed on 7 healthy volunteers, 10 patients with chronic pancreatitis, and 95 patients after pancreatic surgery. The breath test was analyzed with isotope ratio mass spectrometry and the cumulative recovery of (13)CO(2) at 7 hours (% dose (13)C cum 7h) was calculated. The fecal elastase-1 concentration was determined immunoenzymatically.
  
  
  RESULTS
  Both the fecal elastase-1 concentration and the % dose (13)C cum 7h of chronic pancreatitis patients and pancreatic resection patients were less than those of healthy volunteers. In all subjects, % dose (13)C cum 7h correlated with the fecal elastase-1 concentration (n = 112, R(2) = 0.14, P < .01). Accuracy rates for clinical symptoms, including clinical steatorrhea, for the fecal test and the breath test were 62 and 88%, respectively.
  
  
  CONCLUSIONS
  The (13)C-labeled mixed triglyceride breath test might be more useful than the fecal elastase-1 test for evaluating pancreatic exocrine function after pancreatic resection.
authors.affiliation: Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. hsurgeon1017@aioros.ocn.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Morifuji
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hayashidani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sudo
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D002247:Carbon Isotopes; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery; D010196:Pancreatic Elastase / Q000032:analysis; D012016:Reference Values; D014280:Triglycerides / Q000378:metabolism; D055815:Young Adult
chemical_list: D002247:Carbon Isotopes; D014280:Triglycerides; D010196:Pancreatic Elastase