title: Pancreatic duct compliance after secretin stimulation: a novel endoscopic ultrasound diagnostic tool for chronic pancreatitis.
abstract: OBJECTIVE
  Endoscopic ultrasound (EUS) evaluation of pancreatic duct compliance after secretin stimulation (sEUS) along with EUS morphologic examination (EUS) and duodenal fluid [HCO3] measurement (endoscopic pancreatic function test, ePFT) in 1 endoscopic session has not been reported as a means of evaluating for chronic pancreatitis (CP). We evaluated the feasibility of the combined examination and compared EUS measurements of pancreatic ductal compliance with duodenal fluid [HCO3] for diagnosing CP.
  
  
  METHODS
  The study is a prospective case series of patients with suspected CP who underwent a combined EUS, sEUS, and ePFT examination in 1 endoscopic session. The main outcome measures were the feasibility of performing the combination examination and the correlation between ductal compliance and ePFT.
  
  
  RESULTS
  All examinations were completed in 1 endoscopic session, and there were no complications in 35 patients. Although there was a trend toward less change from baseline head and body ductal diameter in patients with CP, only the percent change from baseline in the tail was significant (CP 144.3% vs healthy patients 240.9%, P < 0.01). Regression analysis demonstrated fair correlation between maximum change in ductal diameter and duodenal fluid [HCO3] (r = 0.27).
  
  
  CONCLUSIONS
  Combined EUS, sEUS, and ePFTs are feasible and safe, with preliminary results demonstrating a positive correlation between pancreatic ductal compliance and duodenal fluid [HCO3].
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. timothy.b.gardner@hitchcock.org
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
authors.forename: Edward D
authors.initials: ED
authors.lastname: Purich
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Gordon
mesh_terms: D000328:Adult; D001639:Bicarbonates / Q000378:metabolism; D016009:Chi-Square Distribution; D003187:Compliance; D004386:Duodenum / Q000378:metabolism; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007419:Intestinal Secretions / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009513:New Hampshire; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010186:Pancreatic Function Tests; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012633:Secretin
chemical_list: D001639:Bicarbonates; D012633:Secretin