[Substitution therapy in insufficient external pancreatic secretion]

For assessment and monitoring of adequate enzymatic substitution the authors used repeated examinations of chymotrypsin in the faeces of 19 patients with insufficiency of external secretion (17 patients with chronic pancreatitis and two after duodenopancreatectomy on account of carcinoma of the pancreas). Adequate substitution (chymotrypsin > 6U/g faeces) is individual (1.8-7.2 g pancreatin--Kreon/day). The required dose may be higher in patients with chronic pancreatitis than in conditions following duodenopancreatectomy. When receiving adequate substitution treatment, the patients reported milder complaints, regression of pain and diarrhoea. In two patients with severe signs of malnutrition a satisfactory condition was achieved and their loss of body weight was arrested. The necessary dose of insulin in diabetic patients declined by 4-12 u/day. During treatment no adverse side-effects were found.