Usefulness of a 13C-labeled mixed triglyceride breath test for assessing pancreatic exocrine function after pancreatic surgery.
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.
Nakamura
Hiroyuki
H
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. hsurgeon1017@aioros.ocn.ne.jp
Morifuji
Masahiko
M
Murakami
Yoshiaki
Y
Uemura
Kenichiro
K
Ohge
Hiroki
H
Hayashidani
Yasuo
Y
Sudo
Takeshi
T
Sueda
Taijiro
T
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
D002247:Carbon Isotopes; D014280:Triglycerides; D010196:Pancreatic Elastase