Disproportionate reduction in tryptic response to endogenous compared with exogenous stimulation in chronic...

Area of Science:

• Gastroenterology
• Diagnostic Medicine
• Pancreatic Physiology

Background:

• Chronic pancreatitis (CP) diagnosis can be challenging.
• Evaluating exocrine pancreatic function is crucial for CP assessment.

Purpose of the Study:

• To compare the diagnostic efficacy of the secretin-pancreozymin (SP) test and the Lundh-Borgström (meal) test for chronic pancreatitis.
• To assess the sensitivity and practicality of both diagnostic methods.

Main Methods:

• Compared SP and Lundh-Borgström tests in 17 CP patients and 22 controls.
• Measured bicarbonate concentration/output and peak tryptic activity (PTA) post-secretin/pancreozymin.
• Assessed mean tryptic activity (MTA) after a test meal.

Main Results:

• SP test showed abnormal results in 88% of CP patients.
• Lundh-Borgström test revealed reduced MTA in 16/17 CP patients.
• CP patients exhibited a disproportionately lower tryptic response to meal stimulation compared to SP stimulation.

Conclusions:

• The Lundh-Borgström (meal) test is a sensitive and accessible diagnostic tool for chronic pancreatitis.
• Both tests demonstrated high diagnostic success rates, with the meal test being more practical for general use.
• The SP test offers valuable supplementary information in specialized settings.