Diagnosis of chronic pancreatitis: Functional testing

Area of Science:

• Gastroenterology
• Medical Diagnostics

Background:

• Chronic pancreatitis diagnosis primarily uses imaging like MRCP and MRI.
• Functional tests are valuable when imaging results are inconclusive for pancreatic function.

Purpose of the Study:

• To review available pancreatic function tests.
• To clarify the clinical utility of various diagnostic methods for chronic pancreatitis.

Main Methods:

• Review of commercially available pancreatic function tests.
• Analysis of the sensitivity and specificity of different diagnostic approaches.

Main Results:

• Secretin-pancreozymin and endoscopic tests are the most sensitive for pancreatic function.
• Fat absorption tests and breath tests aid in diagnosing exocrine pancreatic insufficiency.
• Fecal elastase and chymotrypsin assess pancreatic secretion reduction and enzyme replacement therapy compliance.
• Older tests like Lundh and NBT-PABA are obsolete.

Conclusions:

• Imaging is primary, but specific function tests are essential for diagnosing chronic pancreatitis.
• The choice of test depends on the clinical question, from diagnosing pancreatitis to assessing exocrine insufficiency.