PANCREATIC DUCTAL SONOGRAPHIC ABNORMALITIES ARE ASSOCIATED WITH IMPAIRED DUCT-CELL EXOCRINE FUNCTION

Abstract

Background: Few studies have compared endoscopic ultrasound (EUS) with pancreatic function testing (PFT). Therefore, the significance of specific EUS criteria as predictors of exocrine insufficiency is poorly understood. Secretin PFT quantifies bicarbonate secretion as a reflection of duct-cell function (DCF). Aim: Assess DCF in pts with each of 9 EUS criteria. Methods: 198 consecutive pts who underwent both EUS and secretin endoscopic PFT included. Abnormal DCF was defined as a peak bicarbonate concentration <80 mEq/L. Chi Square tests were used to assess proportions. Results: 95/198 had abnormal DCF. Abnormal DCF was most common in patients with cysts (85%), side-branch ectasia (83%), main duct irregularity (79%), and main duct dilation (72%) (Table). Abnormal DCF was least common in patients with hyperechoic duct walls (46%), foci (51%), and strands (51%). Abnormal DCF was observed in only 69% of patients with calcifications.TableConclusions: 1. Duct abnormalities (side-branch ectasia, main-duct irregularity, and dilation) and cysts are significantly associated with impaired DCF. 2. Parenchymal findings (hyperechoic foci, strands, calcifications) are not significantly associated with impaired DCF. Implication: Comparison of EUS with the cholecystokinin PFT to measure acinar-cell function (enzyme-secretory capacity) may establish the functional importance of parenchymal abnormalities.