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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 28, 2008; 14(20): 3149-3158
Published online May 28, 2008. doi: 10.3748/wjg.14.3149
Pancreatic function testing: Here to stay for the 21st century
John G Lieb II, Peter V Draganov
John G Lieb II, Peter V Draganov, University of Florida, Florida 32610, United States
Author contributions: Lieb JG did the literature search and compiled the first draft of the manuscript; Draganov PV contributed to providing the idea for the manuscript and performing editing for content and guiding the overall direction of the manuscript.
Correspondence to: Peter V Draganov, University of Florida, 1600 SW Archer Rd Room HD 602, PO Box 100214 Gainesville, Florida 32610, United States.
Telephone: +1-352-3922877
Fax: +1-352-3923618
Received: January 31, 2008
Revised: March 9, 2008
Accepted: March 16, 2008
Published online: May 28, 2008

The diagnosis of Chronic Pancreatitis (CP) is based on the detection of abnormal structure or function of the diseased pancreas. The pancreatic function tests more accurately determine the presence of CP than tests of structure, especially for early stage disease. The function tests can be divided into two categories: non-invasive and invasive. The invasive “tube” tests can reliably detect mild, early CP, but are only available at a few referral centers and tend to be poorly tolerated by patients. The non-invasive tests are easy to obtain, but tend to perform poorly in patients with early, mild disease. Therefore, no one test is useful in all clinical situations, and a detailed understanding of the rational, pathophysiologic basis, strengths, and limitations of various tests is needed. This review highlights the role of various pancreatic function tests in the diagnosis of CP including fecal fat analysis, fecal elastase, fecal chymotrypsin, serum trypsin, the secretin stimulation test, the cholecystokinin (CCK) stimulation test, the combined secretin-CCK stimulation test, the intraductal and endoscopic secretin stimulation tests, and the functional magnetic resonance imaging of the pancreas after secretin stimulation.

Keywords: Pancreatic function testing, Secretin stimulation test, CCK stimulation test, Fecal elastase, Endoscopic secretin stimulation test, Chronic pancreatitis