Pancreatic Exocrine Function according to Pancreatograms in Patients with Chronic Pancreatitis

Kim, Kwang Hee; Lee, Hong Sik; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

Abstract

BACKGROUND/AIMS: This study was to evaluate the relationship between pancreatic exocrine functional impairment and degree of ductal change observed by endoscopic retrograde pancreatography (ERP) in patients with chronic pancreatitis (CP).
METHODS
We studied 23 patients diagnosed as CP on the basis of clinical history and radiological examinations including ERP. To evaluate exocrine function of the patients, pure pancreatic juice (PPJ) was collected by endoscopic cannulation of main pancreatic duct at 5-min intervals for 30 min under the iv bolus injection of secretin (0.25 CU/kg) and cholecystokinin (40 ng/kg). Pancreatographic findings were based on the Cambridge classification.
RESULTS
In Cambridge I, the mean volume of PPJ secretion, bicarbonate output, and amylase output were reduced by 9.1%, 18.7% and 25.0%, respectively, as compared with controls. In Cambridge II, the mean volume of PPJ secretion was decreased by 41.2%. The outputs of bicarbonate and amylase were reduced by 52.0% and 42.2%, respectively. In Cambridge III, the mean volume of PPJ secretion, bicarbonate output and amylase output were lowered by 74.6%, 81.3% and 72.3%, respectively.
CONCLUSIONS
The impairment of exocrine function should be considered in CP, especially with considerable ductal changes on ERP findings.