Endoscopic retrograde pancreatography and exocrine pancreatic function.

The incidence of pancreatitis has been increasing during the last decennium paralleling a rapid enhancement in alcohol consumption. For many years, diagnostic criteria of chronic pancreatitis were exclusively based on the estimation of the exocrine pancreatic function. New valuable information is provided from endoscopic retrograde pancreaticography (ERP) and pancreatic ultrasonography. In a consecutive series of patients with chronic alcoholism changes in the pancreatogram were demonstrated in approximately 44% of the patients. A comparative study of ERP and exocrine pancreatic function showed that only patients with advanced pancreatic lesions had a significant reduction in pancreatic function. It is suggested that 'subclinical pancreatitis' is frequent among alcoholics. Complementary use of pancreatic ultrasonography and ERP gives a differentiated picture of pancreatic disease and is recommended among the first steps in the diagnostic chain for pancreatic disease.