scholarly journals Exocrine Pancreatic Function Tests: A Review

1989 ◽  
Vol 3 (4) ◽  
pp. 153-161 ◽  
Author(s):  
Yuyuan Li ◽  
Stephen G. Chiverton ◽  
Richard H. Hunt
Keyword(s):  
Imaging Techniques ◽  
Pancreatic Insufficiency ◽  
Pancreatic Disease ◽  
Exocrine Pancreatic Function ◽  
Pancreatic Function ◽  
Screening Tests ◽  
Rational Approach ◽  
Mild Disease ◽  
Pancreatic Function Tests ◽  
Function Tests

Exocrine pancreatic function tests (PFTs) remain of value in the diagnosis and assessment of chronic pancreatic disease. Direct intubation PFTs, using secretin/cholecystokinin or secretin/caerulein as the stimulants, continue to the the 'gold standard', although they are invasive, expensive and time consuming. Tubeless indirect tests, ie, the N-benzoyl-L-tyrosyl-para-aminobe-zoic acid and pancreolauryl tests, have gained increasing acceptance particularly as screening tests. The fecal measurement of chymotrypsin remains a useful screening test for pancreatic insufficiency and fecal fat testing standard for steatorrhea. Radioisotope tests are now outdated. Estimation of pancreatic markers in serum, urine and body fluids are useful when abnormal hut miss mild disease. Combining PFTs with imaging techniques provides a rational approach to early diagnosis and gives a better assessment of the patient with chronic pancreatic disease.

scholarly journals Critical Review of Diagnostic Methods Used in Chronic Pancreatic Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 51-60
Author(s):  
Ivan T Beck
Keyword(s):  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Pancreatic Disease ◽  
Dietary Lipids ◽  
Pancreatic Enzymes ◽  
Diagnostic Methods ◽  
Screening Tests ◽  
Malignant Tumours ◽  
Curative Surgery ◽  
Function Tests

This paper provides a balanced assessment of the various pancreatic function tests and imaging techniques used in the differential diagnosis of chronic pancreatic disease. Function tests that study the digestive capacity of the pancreas (fat absorption of dietary lipids, fluorescein- or radiolabelled fats, bentiromide test, etc) have high specificity, but very low sensitivity. This is because 90% of pancreas has to be destroyed before steatorrhea or creatorrhea occurs. Tests that directly measure pancreatic bicarbonate and protein secretion (secretin test, etc) are more accurate and may detect pancreatic dysfunction even before anatomical changes occur. Measurement of pancreatic enzymes in serum or urine, or the decreased decline of serum amino acids during their incorporation into pancreatic enzymes, are not sufficiently sensitive or specific to help diagnose pancreatic disease. Sensitive and specific tumour markers are not yet available. Thus screening tests are not cost-effective - if they are negative, they do not exclude pancreatic disease; and if positive, they have to be confirmed by more specific tests. Imaging techniques are the most commonly used methods of investigation. The usefulness of abdominal survey films, barium studies, percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography, computed tomographic scan, magnetic resonance imaging and endoscopic ultrasonography is critically reviewed. Most of the radiological methods can be combined with cytology or biopsy. Histology demonstrating malignancy establishes this diagnosis, but negative biopsies do not exclude malignant tumours. Presently only ERCP and endoscopic ultrasound can diagnose cancers sufficiently early to allow for possible `curative' surgery, and only endoscopic ultrasound is capable to stage tumours for the assessment of resectability.

Evaluation of Pancreatic Function Tests in Confirmed Pancreatic Disease

1961 ◽  
Vol 41 (3) ◽  
pp. 233-241 ◽  
Author(s):  
Wilbert J. Henke ◽  
Joseph B. Vacca ◽  
Guy E. Van Goidsenhoven ◽  
William A. Knight
Keyword(s):  
Pancreatic Disease ◽  
Pancreatic Function ◽  
Pancreatic Function Tests ◽  
Function Tests
Sign in / Sign up

Export Citation Format

Share Document