A Comparatibe Study between the Bentiromide Test and Endoscopic Retrograde Pancreatography in Patients with Chronic Pancreatitis

Kang, Jin Kyung; Park, In Suh; Moon, Young Myoung; Chung, Jae Bock; Song, Si Young; Park, Seung Woo

Abstract

BACKGROUND AND AIMS: The bentiromide test has been used to evaluate pancreatic function in patients with chronic pancreatitis. The bentiromide test has some advantages over the traditional pancreozymin-secretin (P-S) test. It does not require duodenal intubation and the analytic method is relatively simple. Some researchers reported that the result of the bentiromide test correlated with that of the P-S test. The advent of endoscopic retrograde pancreatography (ERP) affords the opportunity to analyze the secretory abnormalities of patients with chronic pancreatitis with references to alteration in pancreatic ductal morphology. Precise correlation between the result of the P-S test and the pancreatic ductal morphology obtained by ERP in chronic pancreatitis have not hitherto been established. Furthermore, there is no published report in which a researcher compares tbe bentiromide test with the ERP. In order to document its clinical usefulness in chronic pancreatitis, we performed bentiromide tests in patients with chronic pancreatitis and compared its findings with that of the ERP.
METHODS
Bentiromide tests were performed in 7 control subjects and in 25 patients with chronic pancreatitis who had pancreatic ductal abnormalities on ERP. The cumulative 6 hour urinary recovery rate of para-aminobenzoic acid (PABA) in the urine was determined in each patient and control. The results were compared with the pancreatic ductal abnormalities which had been categorized by Cambridge classification.
RESULTS
The cumulative 6 hour recovery rate of PABA in the urine was significantly lower in patients with chronic pancreatitis (55.8+/-24.2%, p<0.05) than in the control group (82.0+/-10.0%), but among the 25 patients with chronic pancreatitis, 7 patients showed normal recovery rates of PABA. According to the Cambridge classification, the pancreatograms of 25 patients were categorized as mild changes in 4 patients, moderate changes in 5 patients, and severe changes in 16 patients. The 6 hour recovery rate.s of PABA were 56.9+/-21.6% and abnormal in 3 (75%) in mild changes group, 78.4 +/-10.5% and abnormal only in 1 (20%) in moderate changes group, and 47.2+/-23.7% and abnormal in 14 (87.5%) in marked changes group. We could find no significant difference in 6 hour recovery rates of PABA among the groups, nor correlation between the pancreatic ductal changes and the pancreatic exocrine function.
CONCLUSIONS
The bentiromide test can be used in the evaluation of pancreatic exocrine function in patients with chronic pancreatitis, but the test does not correlate with pancreatic ductal changes.