IS INCREASED PANCREATIC PRESSURE RELATED TO PAIN IN CHRONIC-PANCREATITIS

In this study, we investigated the relationship between pain and pancr eatic pressure in patients with chronic pancreatitis (CP). We studied 12 patients with CP undergoing surgery and five controls with cancer o f the pancreatic tail. CP was staged on the basis of morphological (ER P) and functional (serum-pancreolauryl test) criteria. Patients kept d aily records of the intensity of pain on a linear analog scale. Intrao peratively, pressure within the pancreas was assessed by the introduct ion of a fine needle into the pancreatic parenchyma connected to a pre ssure transducer. In controls, pressure was determined in macroscopica lly normal tissue in the head of the pancreas. Pancreatic pressure was significantly higher in CP than in controls (29.9 +/- 3.1 vs 7.2 +/- 1.1 mmHg, p < 0.001). No relationship was found between the pain score and the pancreatic pressure. Pressure was positively correlated with ductal changes (r = 0.831; p < 0.001), but not with exocrine function of the pancreas. Postoperatively, pancreatic pressure fell by 15.3% in four patients with CP in whom pressure assessment was repeated after surgical decompression. We conclude that pancreatic parenchy pressure is not closely related to pain in CP.