Abstract
In the present study we compared sonographic measurements of the main pancreatic duct (MPD) following maximal secretin stimulation (75 CU intravenous in 1 min) in 15 chronic pancreatitis patients (CP) with those of 18 normal control subjects. The mean caliber of the main pancreatic duct was 1.2±0.4 mm in controls and 1.8±0.9 in patients with chronic pancreatitis (P<0.025). In the control group a dilatation of the duct with a peak at the third minute was found. In patients with chronic pancreatitis a flatter profile of the response curve with a slower increase and inconstant return to basal values was found. A statistically significant difference was found between absolute variations of MPD caliber over basal values (1.7±1.06 in controls vs 0.8±0.69 in CP, P<0.005) and the dilatation index [(D max -D)/D] (1.31±0.6 in controls vs 0.66±0.69 in CP, P<0.005). The mean percent increase at the third minute was 131% in control subjects vs 53% of patients with CP (P<0.0005). In the five cases of CP showing a caliber increase >100%, a persistent dilatation (100–200%) was found 15 min after secretin administration. At this time, the mean percent increase over basal value in controls was 25%. If we accept an abnormal response to secretin as evidence of pancreatic pathology, the absent or decreased (<50%) MPD dilatation after secretin and/or the persistence of a dilatation >100% at the 15 min, the sensitivity of this provocative test in discriminating early chronic pancreatitis from controls reaches the 86.6% (13 of 15 cases). Results of the present study suggest that the ultrasonographic examination of the main pancreatic duct (MPD) after maximal secretin stimulation may reveal morphological changes not visible under basal conditions, thus helping to diagnose early chronic pancreatitis (CP).
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Bolondi, L., Li Bassi, S., Gaiani, S. et al. Impaired response of main pancreatic duct to secretin stimulation in early chronic pancreatitis. Digest Dis Sci 34, 834–840 (1989). https://doi.org/10.1007/BF01540267
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DOI: https://doi.org/10.1007/BF01540267