Measuring the Diameter of the Pancreatic Duct During Secretin Stimulation Is Not a Reliable Test for Pancreatic Insufficiency

MARCH 30, 2016
Andrew Smith
A trial designed to find a quick and definitive way to test for exocrine pancreatic insufficiency in cystic fibrosis patients has instead discovered another feasible method that does not work.
Investigators from Poland enrolled 37 cystic fibrosis patients in the trial and used secretin-enhanced magnetic resonance cholangiopancreatography (SE-MRCP) to compare the pancreatic duct diameters of the 21 pancreatic insufficient patients and the 16 pancreatic sufficient patients.
Images were taken of the head, body and tail of each patient’s pancreatic duct 1, 2, 3, 5 and 10 minutes after initial secretin administration, but only 2 of those 15 sets of images showed any measurable difference between the 2 patient groups.
The diameter of the pancreatic duct, as measured at the head of the pancreas, was slightly larger in pancreatic insufficient patients than in pancreatic sufficient patients at 5 minutes (median, 2.0 mm; interquartile range [IQR], 1.6 mm to 3.0 mm vs. median, 2.0 mm; IQR, 1.0 mm to 2.0 mm; p=0.047) and at 10 minutes (median, 2.0 mm; IQR, 1.4 mm to 2.0 mm vs median, 1.0 mm; IQR, 1.0 mm to 2.0 mm; p=0.040).

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