Evaluation of pancreatic exocrine secretion using ^<13>C-dipeptide (benzoyl-L-tyrosyl-[1-^<13>C]alanine) breath test

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Objective : We investigated whether a breath test using benzyl-L-tyrosyl-[1-^<13>C]alanine (Bz-Tyr-Ala) allows assessment of pancreatic exocrine function. Methods and Subjects : Bz-Tyr-Ala was orally administered, and changes in ^<13>CO_2 were expressed as Δ‰. The breath test was performed in chronic pancreatitis patients and healthy subjects in a preliminary study, and subsequently in 17 pancreatoduodenectomy patients, to examine the difference between the results obtained at the times of pancreatic tube insertion and removal, the relationship between breath test results after tube removal and the volume of pancreatic juice drained, and the difference in results between the presence versus the absence of histological changes of chronic pancreatitis. Results : The Δ‰ was lower in the chronic pancreatitis patients than in healthy subjects. In the postoperative patients, the Δ‰ was higher at tube insertion than at tube removal. The correlations of the Δ‰ with the maximum volume of pancreatic juice, its mean volume, and pancreatic juice amylase levels were 0.865, 0.757 and 0.853, respectively. The Δ‰ was lower in 11 patients with than in 6 patients without histological changes of chronic pancreatitis. Conclusion : These results suggest that the Bz-Tyr-Ala breath test can measure pancreatic exocrine function.