The diagnosis of chronic pancreatitis in patients with characteristic symptoms but normal pancreatic imaging is challenging.
Assessment of pancreatic function through secretin pancreatic function testing has been advocated in this setting, but its diagnostic accuracy is not fully known.
Dr Gyanprakash Ketwaroo and colleagues from Massachusetts, USA performed a retrospective review of patients who received secretin pancreatic function testing at their tertiary care institution between 1995 and 2008 for suspected chronic pancreatitis.
For all patients, medical records were reviewed for evidence of subsequent development of chronic pancreatitis by imaging and/or pathology.
Patients were then categorized as 'true positive' or 'true negative' for chronic pancreatitis based on follow-up imaging or histologic evidence.
In all, 116 patients underwent secretin pancreatic function testing.
Of the 27 patients who tested positive, 7 were lost to follow-up.
|The sensitivity of the secretin pancreatic function testing was 82%|
|American Journal of Gastroenterology|
The doctors found that of the remaining 20 secretin pancreatic function testing-positive patients, 9 developed radiologic or histologic evidence of chronic pancreatitis after a median of 4 years.
Of the 89 patients who had negative secretin pancreatic function testing testing, 19 were lost to follow-up.
Of the remaining 70 patients, 2 were eventually diagnosed with chronic pancreatitis based on subsequent imaging/histology after a median follow-up period of 7 years.
The research team found that the sensitivity of the secretin pancreatic function testing in diagnosing chronic pancreatitis was 82%, with a specificity of 86%.
The team observed that the positive predictive value of chronic pancreatitis was 45%, with a negative predictive value of 97%.
Dr Ketwaroo's team concludes, "In patients with suspected early chronic pancreatitis and normal pancreatic imaging, secretin pancreatic function testing is highly accurate at ruling out early chronic pancreatitis with a negative predictive value of 97%."