Pathological pancreatic exocrine function and duct morphology in patients with cholelithiasis

Most authors claim alcohol consumption to be the only relevant reason for c hronic pancreatitis. However, gallstones might cause this disease, as they do cause acute pancreatitis. In this study 91 gallstone patients and 94 age -matched controls were investigated concerning exocrine pancreatic function (fecal elastase-l concentrations). Furthermore x-rays of 100 consecutive E RCP patients were evaluated for differences concerning pancreatic duct chan ges between patients with and without evidence of cholelithiasis. Pathologi cal elastase 1 levels were more frequent in gallstone patients (30,8%) as c ompared to age-matched controls (19%). Symptoms such as upper abdominal pai n, bloating, and fat intolerance were reported more often in gallstone pati ents. In ERCP of gallstone patients (N = 60), 77% were found to have chroni c pancreatitis according to the Cambridge classification, while in nongalls tone-patients (N = 32) 47% had chronic pancreatitis. In conclusion, accordi ng to these data a pathophysiological connection between gallstones and chr onic pancreatitis appears to be probable.