Evaluation of Tests of Pancreatic Function in Chronic Pancreatic Disease

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Abstract
Pancreatic function tests were studied in 81 patients with chronic pancreatic disease. These tests included pancreozymin-secretin stimulation, fasting serum enzyme levels, starch tolerance, triolein I 131 test, and chemical determination of fecal fat. Abnormal results were obtained by analysis of duodenal contents in 86%, by serum enzyme response in 19%, and by elevated fasting serum enzyme levels in 9%. An abnormal serum enzyme response was observed more frequently in patients with a mild degree of pancreatic exocrine insufficiency. Abnormal results were obtained by the glucose tolerance test in 69%, the starch tolerance test in 35%, and the triolein I 131 test in 36%. These abnormal results were observed more frequently in patients with advanced pancreatic exocrine insufficiency. Analysis of duodenal contents was the most sensitive and reliable test in the diagnosis of chronic pancreatic disease.