PRELIMINARY OBSERVATIONS OF A PROSPECTIVE CROSS-OVER TRIAL COMPARING ENDOSCOPIC AND DREILING TUBE (DT) COLLECTION METHODS FOR PANCREATIC FUNCTION TESTING (PFT)

Abstract

Purpose: Collection of hormone-stimulated duodenal fluid using a DT is considered the gold standard PFT; however this method is cumbersome and not widely available. We have developed an endoscopic test (ePFT) which eases collection of duodenal aspirates. Our aim is to compare peak duodenal fluid [HCO3−] obtained by DT and ePFT methods after secretin stimulation. Methods: Healthy subjects (HS) and CP pts were randomized to secretin DT or ePFT, then crossed over to the remaining test after a minimum 1-wk washout. An age/weight-based sedation bolus was used for each test. Dreiling tube method: endoscopic placement of a DT was confirmed using fluoroscopy. After IV synthetic porcine secretin (0.2 mcg/kg, ChiRho-Clin, Inc.), duodenal fluid was collected in 15-min increments for 1 hour. Endoscopic Pancreatic Function Test (ePFT) method: 1) Upper endoscopy was performed using a 6-mm endoscope, 2) IV secretin, 3) duodenal aspirates were obtained every 5 min for 1 h and 4) fluid was sent for [HCO3−] analysis on autoanalyzer. Results: 6 HS and 4 CP pts have been randomized to date. All patients tolerated both procedures without complication. Median peak [HCO3] for DT and ePFT for the HS was 103 and 109 mEq/L, respectively (p = 0.31). Median peak [HCO3] for for the CP pts was 70 mEq/L for both tests (p = 0.88). There was a significant correlation in peak [HCO3] obtained by each method (r = 0.7, p = 0.03, Pearson).[figure 1]Figure: Peak [HCO3 −] for EPFT and DPFTConclusions: 1. The peak [HCO3−] observed with each collection method are similar. 2. The peak [HCO3−] obtained by the E-PFT shows a good correlation with peak [HCO3−] obtained by a DT. 3. Patients are continuing to be enrolled into this prospective trial.