摘要:

To evaluate the effectiveness of exocrine function tests in diagnosing chronic pancreatitis (CP), we compared the sensitivity and specificity of duodenal intubation with tubeless tests. While the secretin test (ST) was necessary to diagnose CP, especially in noncalcified CP, and tubeless tests demonstrated insufficient sensitivity to diagnose CP, the combination assay of tubeless tests was specific enough to diagnose severe exocrine dysfunction. Our studies found the sensitivity of secretin testing to diagnose definite CP to be 87%. In patients with probable CP, 60% had mild exocrine insufficiency and 40% had normal function. The false-positive rate of the ST results in nonpancreatic diseases, except diabetes mellitus, was 5%. The correlation between morphological changes in endoscopic retrograde pancreatography (ERP) and exocrine function evaluated by ST was 74%. In patients with calcified CP, 81 % had parallel results between ERP and the ST, but in non- calcified CP, 47% had parallel results. In patients with severe or moderate exocrine insufficiency demonstrated by ST, abnormally low levels were observed in 63% byN-benzoyl-L-tyro- syl-p-aminobenzoic acid (BT-PABA) test, 61% by fecal chymotrypsin test (FCT), and 44% by pancreatic amylase (PA). In patients with normal exocrine function demonstrated by ST, abnormally low levels were observed in 28% by BT-PABA test, 28% by FCT, and 10% by PA. A combination assay of BT-PABA test, FCT, and PA improved the specificity for diagnosing CP but not the sensitivity.

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The diagnosis of chronic pancreatitis usually is based on imaging studies, pancreatic function tests, and the presence of characteristic clinical features. In Japan, diagnostic criteria for chronic pancreatitis were established in 1983 and revised in 1995. Under the new criteria, the secretin test (a duodenal intubation test) and the combination of nonivasive tests,N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA) and fecal chymotrypsin (FCT), have been recommended for evaluating exocrine pancreatic function in patients with chronic pancreatitis. In the present study, the diagnostic value of these two noninvasive tests was compared to the secretin test. Although noninvasive tests are less sensitive and specific for determining exocrine pancreatic impairment than the secretin test, greater reliability for diagnosing chronic pancreatitis can be obtained by performing the BT-PABA and fecal chymotrypsin tests simultaneously. Combining BT-PABA and FCT is easy and useful and should be performed at least twice to obtain reliable results.

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Islet autotransplantation prevents diabetes in some patients after total pancreatectomy. Pancreatectomy is done at most hospitals but islets are prepared at only a few centers. We report a case in which the pancreas was sent to a laboratory half a continent distant from the operative site, and islets were prepared and returned to the original hospital for autotransplantation 16 h after resection. At 10 months posttransplantation, the patient is normoglycemic and insulin independent, with an appropriate insulin secretion in response to glucose. Endocrine function can be retained after pancreatectomy even if the islets are isolated at a remote laboratory, and autotransplantation could be offered to patients without the need to travel. This outcome implies that the typical handling and processing of a pancreas destined to yield an islet allograft should not prevent the recovery of a sufficient number of viable β cells to establish insulin independence in type 1 diabetic recipients.

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0885-3177    

出版商:OVID    

年代:1997

数据来源: OVID