Exocrine Pancreatic Function Tests: A Review

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 Radioisotope tests are now outdated.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