[Chemical Investigation of Chronic Pancreatitis]

We differentiate indirect and direct methods. The indirect methods include the examination of the blood (ESR, blood picture, electrolytes, especially calcium, for the exclusion of hyperparathyroidism, status of fat and liver enzymes, activity of alpha-amylase and lipase. More informative than a serum determination is the measurement of the amylase activity in the 24-hour urine. The detection of chymotrypsin in the stool can be recommended as an investigative test also for use in general practive in collaboration with a central laboratory.- The direct methods include investigation of the duodenal juice with measurement of pH, bicarbonate, of the activities of chymotrypsin, trypsin, lipase and amylase. For excluding of a disturbance of the carbohydrate metabolism in addition to blood sugar determinations, glucose tolerance and tolbutamide tests, the determination of insulin activity is indicated.