Exocrine Pancreatic Dysfunction

Abstract

Exocrine pancreas dysfunction is a potential basis for accurate diagnosis of chronic pancreatitis. However, the dysfunction evaluated with various diagnostic tools is not necessarily specific for chronic pancreatitis. At present, the secretin test as a duodenal intubation test and the fecal chymotrypsin activity assay are difficult to apply in clinics in Japan. Now, the BT-PABA test is the only one available for examination of the exocrine pancreatic function. The clinical meaning of the test has been well established and it is a noninvasive. However, reproducibility based on exclusion of the influence of PABA metabolism in vivo is necessary for the estimation of the test. The diagnosis of exocrine dysfunction is allowed by several apparent decreases in the results of BT-PABA test. The mainstream clinical diagnosis for the earlier phase of chronic pancreatitis is based on imaging diagnostic procedures that show histological changes of the pancreas. In the revised criteria, exocrine pancreatic dysfunction is one of the six diagnostic characteristics of chronic pancreatitis.