The effect of prior sphincterotomy on the secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP).
OBJECTIVE
A lack of pancreatic duct compliance and decreased duodenal filling on secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP) has been noted in patients with chronic pancreatitis. Whether endoscopic sphincterotomy can affect pancreatic duct compliance and duodenal filling on diagnostic s-MRCP is unknown.


METHODS
A retrospective review of patients referred to the authors' clinic from December 2006 to December 2007 was performed. Those patients with no evidence of chronic pancreatitis who underwent s-MRCP were studied. Findings on s-MRCP were analyzed, specifically noting change in pancreatic duct diameter size from baseline to maximum dilation and duodenal filling after secretin administration (0.2 microg/kg intravenous dose of human secretin).


RESULTS
Of the 34 patients studied, 12 underwent endoscopic sphincterotomy, and 22 had intact sphincters of Oddi. In the sphincterotomy group, there was a mean change of 0.2 cm (range, 0.0-0.4 cm), while in the nonsphincterotomy group, the mean change was 0.9 cm (range, 0.3-2.0 cm) after secretin administration. The difference was significant (P < .005).


CONCLUSIONS
Endoscopic sphincterotomy significantly decreases pancreatic duct dilation in response to secretin on s-MRCP. However, further studies are required to determine the effect sphincterotomy has on the amount of duodenal filling and the rate at which duodenal filling occurs.
Chopra
Ashish
A
Division of Gastroenterology and Hepatology, St Louis University School of Medicine, 3635 Vista Avenue, St Louis, MO 63110, USA.
Alkaade
Samer
S
Balci
N Cem
NC
Burton
Frank
F
D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology* / Q000601:surgery*; D010195:Pancreatitis / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012633:Secretin; D012680:Sensitivity and Specificity; D016717:Sphincterotomy, Endoscopic
D003287:Contrast Media; D012633:Secretin