MODIFIED SERUM PANCREOLAURYL TEST IN CHRONIC-PANCREATITIS - EVALUATION IN COMPARISON TO ENDOSCOPIC RETROGRADE PANCREATOGRAPHY

Background/Aims: The aim of this study was to assess the applicability and accuracy of the modified serum pancreolauryl test (sPLT) in patie nts with chronic pancreatitis (cP). Methodology: We compared the resul ts of-a modified serum pancreolauryl test to morphological changes as detected by endoscopic retrograde pancreatography (ERP) in 60 patients with a history suggesting chronic pancreatitis were compared. Serum f luorescein was measured 30, 60, 120, 150, 180 and 240 minutes after th e ingestion of fluoresceindilaureat, a standardized breakfeast, and IV administration of secretin (1 U/kg) and metoclopramide (10 mg). Furth ermore, the results of sPLT and ERP were compared to the findings on a bdominal ultrasonography. Results: Forty of 60 patients suffered from cP according to ERP criteria. With a fluorescein cut-off point of 4.5 mu g/ml, sPLT reached a sensitivity of 68% and a specificity of 50%. A ccording to the ROC curve, the optimal cut-off point was at a fluoresc ein level of 4.1 mu g/ml; however, predictive accuracy was only slight ly improved af this point. In the subgroup of patients with advanced p ancreatic duct changes (n = 23), however, sPLT reached a sensitivity o f 87% with 16 patients showing a peak fluorescein concentration below 2.5 mu g/ml.Conclusion: Like other indirect pancreatic function tests, modified sPLT provides good recognition of patients with advanced cP but poor identification of patients with mild or moderate cP, leading to an unsatisfying overall performance of the test.