triolein and Pancreatitis--Chronic

Despite the advances in pancreatic imaging, there continues to be a need to measure exocrine function to determine which patient requires enzyme supplementation. To evaluate the potential use of a rapid endoscopic test that can be conducted by nonacademic centers, we investigated whether concentration of trypsin in food-stimulated secretion is related to trypsin synthesis and secretion.. Subjects include 22 chronic pancreatitis patients (10 mild, 5 moderate, and 7 severe radiological disease) and 11 healthy controls. During upper gastrointestinal endoscopy, pancreatic secretion was stimulated by a single 30-mL duodenal injection of an enteral diet, followed 5 minutes later by periampullary juice aspiration (endoscopic pancreatic function test [ePFT]). This was followed by a conventional 2-hour marker-perfusion diet-stimulated pancreatic trypsin secretion and synthesis study (2-hour PFT [2hPFT]).. Severity of radiological disease was associated with a progressive loss of enzyme secretion measured by the 2hPFT. The endoscopic PFT correlated positively with 2hPFT (r2 = 0.48; P < 0.0001) and an activity of less than 5% of the average normal had a 96% specificity and 75% sensitivity for the detection of pancreatic insufficiency as defined by a loss of greater than 90% of pancreatic secretion.. The diagnostic power of endoscopy may be enhanced by the collection of a pancreatic juice sample after enteral feed stimulation because measurement of the trypsin content will identify chronic pancreatitis patients who will be benefited by enzyme supplementation.

Topics: Adult; Amylases; Breath Tests; Carbon Radioisotopes; Dietary Fats; Eating; Endoscopy, Digestive System; Female; Humans; Lipase; Male; Middle Aged; Pancreas, Exocrine; Pancreatic Juice; Pancreatitis, Chronic; Radionuclide Imaging; Sensitivity and Specificity; Severity of Illness Index; Triolein; Trypsin

Topics: Bile Acids and Salts; Fats, Unsaturated; Gastrointestinal Agents; Pancreatic Extracts; Pancreatitis; Pancreatitis, Chronic; Pepsin A; Salts; Triolein

Topics: Feces; Lipids; Oleic Acid; Oleic Acids; Pancreatitis; Pancreatitis, Chronic; Triolein

Topics: Fats; Humans; Lipid Metabolism; Pancreatitis; Pancreatitis, Chronic; Recurrence; Triolein