Endoscopic Ultrasound with Secretin Stimulation (SSEUS) in the diagnosis of obstructive chronic pancreatitis

Abstract

ENDOSCOPIC ULTRASOUND WITH SECRETIN STIMULATION (SSEUS) IN THE DIAGNOSIS OF OBSTRUCTIVE CHRONIC PANCREATITIS. MF Catalano, JE Geenen, MI Schmalz, D] Gwnen, A Ross, WJ Hogan. St. Luke's Medical Center, Milwaukee, WI Chronic pancreatitis (CP) may be difficult to diagnose with existing modalities. The gold standard Secretin Test (ST) is cumbersome and may not identify the early stages of CP. Alternatively, ERCP is complicated by acute pancreatitis in up to 10% of cases. EUS has shown to be useful in the diagnosis of CP. Identification of obstructive forms of CP are particularly important since mechanical correction may significantly impact on prognosis. AIM: To evaluate the affect of secretin stimulation on the pancreatic duct (I'D) diameter in pts with suspected obstructive chronic pancreafitis, METHOD: 20 pts with no history of pancreas disorder served as controls. SSEUS was performed after administration of secretin (1U/kg). PD diameter was measured at the splenic/superior mesenteric vein confluence at baseline and l-rain intervals for 15 rain. Abnormal SSEUS was defined as a sustained (2_lmm) increase of the PD over the entire 15-rain recording interval. 16 of 20 control patients showed no change on SSEUS; 4 pts had a 1 mm dilation within 2-3 mia but was not sustained ( < 10 rain). In addition 40 pts (22M,18F, age 32-72) with acute recurrent pancreatitis (ARP) underwent evaluation by ST, ERCP and EUS. Etiology: Divisum= 14, ETOH=10, idiopathic=ll, papillary stenosis=4, familial=l. RESULTS: Results of the 40 pts with ARP are shown below.