Pancreatic exocrine function

Summary The relative value of certain tests of pancreatic exocrine function was assessed by the sequential administration of (1) an augmented dose of secretin, (2) an augmented dose of pancreozymin, and (3) a test meal. Eighty-one individuals were studied—namely, the control group of 47 persons (24 healthy volunteers and 23 patients with nonpancreatic disease) and a group of 34 patients with pancreatic disease. The latter group included 17 patients with chronic pancreatitis: 2 with subacute relapsing pancreatitis and 15 with carcinoma of the pancreas. Measurements of volume, bicarbonate output (peak and total), and bicarbonate concentration (maximal and 60-min.) were made with and without reference to body weight, after administration of secretin. Concentrations and outputs of trypsin and amylase were measured after the administration of pancreozymin and the test meal.The augmented secretin test yielded the most reliable results, both in indicating pancreatic disease and in differentiating between chronic pancreatitis and pancreatic carcinoma; measurements of volume output per kilogram of body weight, peak or total bicarbonate output, and maximal bicarbonate concentration were the most appropriate data for these purposes. Satisfactory, but less reliable, results were those of secretion that followed the administration of an augmented dose of pancreozymin or a test meal; the findings after these two tests were comparable. Mayo Clinic Rochester, Minn. 55902This investigation was supported in part by Research Grant AM-06908 from the National Institutes of Health, U. S. Public Health Service.We are grateful to our colleagues for referring patients for this study, and to Sister Victor, Director of Dietetics, St. Marys Hospital, Rochester, Minnesota, for preparation of the special test meal.Research assistant in gastroenterology and recipient of a Wellcome Travel Grant.Research assistant in biochemistry.