Pancreatic function test: Indirect tests, fecal fat analysis, secretin-pancreozymin-test
Lembcke B., Braden B., Stein J., Lankisch PG.
Pancreatic function tests allow to establish the diagnosis of chronic pancreatitis in cases when imaging methods give negative or inconclusive results, and they allow to assess severity of exocrine pancreatic function. In the clinical setting the today available methods are suitable to meet the diagnostic or therapeutically relevant questions arising about exocrine pancreatic secretion. For their appropriate use, however, the strengths and weaknesses of the respective tests should be known to the clinician. Direct pancreatic function tests such as the secretin-pancreozymin-test are cumbersome and expensive, clinical indications are rare. For the detection of moderate-to-severe pancreatic insufficiency more convenient and cheaper indirect tests are available, and for the monitoring of pancreatin supplementation direct pancreatic function test are not only dispensible but inappropriate. Among the numerous published pancreatic function tests today relevant, validated and emerging rational methods are described and their diagnostic use is pointed out. Thereby it is shown that only few tests are mandatory for a rational and valid assessment of pancreatic function, but none of the tests allows to meet all questions with one method.