Parenchymal PBF is decreased in a feline model of chronic pancreatitis (Reber, et al. Gastroenterology 1992:103:652-9). Intraductal PBF measurement using a hydrogen (H2) gas clearance technique was validated by microsphere methodology. AIMS: 1) To develop the same methodology for the measurement of human PBF and 2) to test its feasibility and safety in patients. METHOD: A 5 French probe was created using an available ERCP cannula (5-4-3 catheter®, Microvasive-Boston Scientific, Boston) and a platinum wire. The distal tip of the wire served as the contact electrode. The other end of the wire was connected to a computer for signal acquisition. Patients scheduled for ERCP were recruited for the study with informed consents. The subjects breathed 3% H2 in air through a nasal cannula for ten minutes before probe insertion into the pancreatic duct. Following probe insertion the gas was turned off and a H2 desaturation curve was obtained in order to measure PBF. RESULTS. 17 patients were enrolled. One of them did not undergo the study because of failed ERCP. Cannulation of the main pancreatic sphincter and probe placement within the mid-Wirsung duct was successful in all other subjects.. Each probe placement was accomplished within two minutes, with the maximum of 3 passes per patient. No additional medication was needed for sedation during the blood flow measurement except for 3 subjects. Patient reaction, oxygen saturation and vital signs did not alter during hydrogen delivery and blood flow measurements. Time spent for each session was 8 minutes except when secretin was given as a two-step study. Signals acceptable for computer data analysis were attained in 14 patients (82%). 2 patients (13%) developed mild pancreatitis. CONCLUSION: 1) This is the first successful non-operative pancreatic blood flow study in humans. 2) The catheter probe was easy to place inside the main pancreatic duct and produced steady and meaningful data. 3) Mild pancreatitis, which could be a result of the ERCP itself, was the only complication associated with this technique.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging