[Comparison of three indirect pancreatic function tests in severe chronic pancreatitis--personal observations]

The aim of the presented study was a comparative evaluation of the three indirect pancreatic function tests: pancreolauryl-test (PLT), NBT-PABA test and faecal chymotrypsin (CH) efficacy in detecting pancreatic exocrine function impairment in advanced chronic pancreatitis (acp). 30 patients with severe chronic pancreatitis (marked structure changes in ultrasound and CT following Cambridge criteria) confirmed by abnormal secretin-cerulein test (SCT) and 10 healthy controls underwent PLT, NBT-PABA and CH tests. The degree of pancreatic function impairment in SCT was classified following Malfertheiner into 3 subgroups: 1-mild, 2-moderate and 3-severe. All the indirect pancreatic function test were performed using commercially available kits (Temmler-Werke for PLT, Hoffman-La Roche for NBT-PABA and Boehringer Mannheim for CH) according to manufacturer instructions. PLT revealed changes in 27 (0.9), NBT-PABA-in 25 (0.83) and CH-in 22 (0.73) patients with acp. On the other hand those test have shown normal pancreatic function: PLT-in 0.9, NBT-PABA-in 0.7 and CH-in 0.8 in control group. The sensitivity of those test was increased up to 0.94 (PLT and NBT-PABA) and up to 0.88 (CH) and in the subgroup of severely impaired pancreatic function test in SCT. The concomittant use of two indirect pancreatic function tests caused increase of sensitivity up to 0.93. Our results suggest that with PLT, NBT-PABA and CH impaired pancreatic function may be succesfully recognized in advanced chronic pancreatitis, in particular, when two of them are applied concomittantly.