Assessment of exocrine pancreatic dysfunction in chronic pancreatitis

The clinical diagnosis of chronic pancreatitis is usually based on imaging studies, pancreatic function tests, and the presence of characteristic clin ical features. In Japan, diagnostic criteria for chronic pancreatitis were established in 1995, The secretin test (a duodenal intubation test) and the combination of noninvasive tests, N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA) and fecal chymotrypsin (FCT), have been recommended for evaluatin g exocrine pancreatic function in patients with chronic pancreatitis. In th e present study, the diagnostic value of these two noninvasive tests was co mpared to the secretin test. Although noninvasive tests are less sensitive and specific for determining exocrine pancreatic dysfunction than the secre tin test, greater reliability for diagnosing chronic pancreatitis can be ob tained by performing the BT-PABA and FCT simultaneously, Assessment of exoc rine pancreatic function is important not only to diagnose chronic pancreat itis but also to decide a treatment method with pancreatic enzyme preparati on.