[Preoperative laboratory diagnosis in pancreatic surgery--what is necessary?]

Some aspects of preoperative laboratory investigations are discussed in pancreatic surgery. Diagnosis of acute pancreatitis is not a major diagnostic problem with pancreatic enzyme measurement and with further regard to medical history and clinical presentation. However, early assessment of the prognosis of acute pancreatitis still remains a clinical challenge. The determination of C-reactive protein (CRP) and lactate dehydrogenase (LDH) is used successfully in clinical practice. The values of different serum markers are described in prognostic evaluation of acute pancreatitis, and some direct and indirect pancreatic-function tests are compared in preoperative management of patients with chronic pancreatitis. The most sensitive direct pancreatic-function test is the secretin-pancreozymin test (SP-test), among the indirect function tests estimation of faecal elastase 1 is superior. The significance of tumor marker measurement is described in pancreatic cancer.