Endoscopic retrograde pancreatography and the exocrine pancreatic function in chronic alcoholism

In a consecutive study of chronic alcoholics admitted for X-ray-negative dyspepsia, endoscopic retrograde pancreatography (ERP) showed pancreatographic changes in 47% of the patients, whereas exocrine pancreatic dysfunction was found in 19%. Only patients with severe parenchymatous damage on ERP had subnormal output of pancreas lipase. In patients with less severe pancreatographic changes the pancreas function test was normal. It was suggested that ERP is a more sensitive method for detection of minor and moderate duct abnormalities in pancreatic inflammatory disease. A clinical diagnosis of pancreatitis had been made in only 22% of the patients before the present investigation. Thus subclinical pancreatitis may be more frequent among alcoholics than previously recognized and should be suspected in cases of unclarified dyspepsia in patients with long-standing abuse of alcohol.