THE DIAGNOSTIC INFORMATION OF BILIARY TRACT DISEASES USING PANCREOZYMIN-SECRETIN TEST: Isolation of Bacteria and Parasites

The Pancreozymin-Secretin test was performed in a total of 510 cases of digestive diseases: It was confirmed that this test is useful not only for the evaluation of pancreatic exocrine function but also for the diagnostic information for biliary tract diseases. The value of the icterus index in P10, which was a fraction of duodenal juice collected 10 minutes after intravenous injection of Pancreozymin (1 unit/kg), was 292.4±100.3 (mean±S.D.) in 30 normal subjects, and its value in S40 and S60, which were fractions of duodenal juice collected 40 minutes and 60 minutes after intravenous injections of Secretin (1 unit/kg), was 1.8±2.2 and 2.3±3.6, respectively. Therefore, the normal value of icterus index was over 100 for P10 and under 10 for both S40 and S60 for clinical use. The icterus index was decreased in P10 and increased in S40 and S60 in cases with biliary tract diseases. However, no significant difference was observed in the volume of each fraction collected from patients with biliary tract diseases compared to that of normal subjects. Abnormal value of icterus index or volume of duodenal juice collected by the P-S test was also observed frequently in patients with pancreatic cancer, chronic pantreatitis, chronic hepatitis, liver cirrhosis and diabetes mellitus. The isolated bacteria could be determined to be pathogens when they numbered over 105 cell/ml in the duodenal juice obtained by duodenal drainage methods. However, the apperance of gram-positive bacteria such as α-Streptococcus, Micrococcus, Staphylococcus aureus and Staphylococcus epidermides were thought to be contaminats because almost all were under 105 cells/ml and rarely isolated from bile collected by sugical procedure. Furthermore, parasites such as Giardia lambria, Isospora belli and Strongyloides stercoralis were found in 2.2% of the duodenal juice collected by P-S test. (11 out of 510 cases).