Comparison of Secretin-enhanced Magnetic Resonance Cholangiopancreatography (S-MRCP) to Endoscopic Pancreatic Function Test (ePFT) in Diagnosing Pancreatic Exocrine Insufficiency

Surgical resection offers the only hope of cure for pancreatic adenocarcinoma. While
perioperative mortality rates have declined in recent years, pancreatic resection is still
associated with significant postoperative malnutrition, maldigestion, and glucose
intolerance, mostly as a result of pancreatic insufficiency. Quantifying individual
pancreatic function remains a challenge, but is essential in improving the survival and
quality of life of pancreatic cancer patients. Secretin-enhanced magnetic resonance
cholangiopancreatography (S-MRCP) has recently emerged as a widely-accepted noninvasive
technique to assess morphological changes in pancreatic ducts, as well as functional
secretory capacity of the gland. The aim of our study is to evaluate S-MRCP as a means to
evaluate for pancreatic exocrine insufficiency. This will be a prospective study of twelve
patients who have undergone pancreatic resection and who have symptoms of abdominal pain,
steatorrhea or weight loss. We will be comparing quantitative parameters of S-MRCP (maximal
change in pancreatic duct diameter and volume before and after secretin administration) with
endoscopic pancreatic function testing (maximal bicarbonate concentration in duodenal
aspirate after secretin administration).