The recent development of endoscopic retrograde cholangiopancreatography (ERCP) now permits the collection of pure human pancreatic secretions via duodenoscopic cannulation. Study objectives are evaluation of exocrine pancreatic function and
analysis of
pure pancreatic juice collected by use of ERCP technique in subjects without pancreatic disease. From March to July 1993, we performed ERCP and collection of pure pancreatic juice in 10 patients without evidence of pancreatic disease. After deep
cannulation of pancreatic duct with Teflon catheter, we aspirated basal collection for 5 minutes. After then, 100 units of secretin (Secrepan(r)) was given intravenously and pure pancreatic juice was collected at five minutes intervals for
fifteen
minutes. Flow rate, bicarbonate concentration, bicarbonate output, protein concentration, calcium concentration, pancreatic enzymes (amylase, lipase) and tumor markers (CEA, CA 19-9) in pancreatic juice were investigated.
@ES The results were as followings:
@EN 1) volumes, bicarbonate concentrations and bicarbonate output of pancreatic juice were significantly increased after secretin stmulation.
2) concentrations of amylase and lipase was not significantly changed after secretion stimulation.
3) concentrations of protein and calcium were higher in basal collections.
4) CEA level was less than 3ng/ml in all patients and median CA 19-9 level was 262.7IU/ml (66.2-7740).
5) There was no significant side effects or complications during and after examination.
We concluded that pure pancreatic juice sampling by ERCP technique was safe, rapid and practical method. Adequate amount of pancreatic juice could be aspirated after secretin stimulation for analyssi of pancreatic juice such as biochemical
enzymatic and
tumor marker studies. Further investigation is expected for various pancreatic diseases.
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