Pancreatic function after endoscopic and surgical occlusion of the pancreatic duct in patients with chronic pancreatitis.

Complex monitoring of pancreatic function was done after 18 endoscopic or surgical occlusions of the pancreatic duct in 15 patients with chronic pancreatitis. The indirect function tests (starch tolerance test, Lipiodol test and fat loading) as well as the direct tests (secretin-pancreozymin and Lundh tests) demonstrated only moderate pancreatic insufficiency. Overall values of the Lundh test performed before and after the treatment in 10 cases did not change significantly. The surgical procedure decreased pancreatic function somewhat more effectively, but the symptom-free "burned-out" state was only rarely achieved. Even glucose tolerance slightly diminished after treatment. The uneven results of obstruction therapy were attributed to the recovered exocrine function of the pancreas. Patients with severe pancreatic insufficiency or proximal resection of the pancreas seem to be better candidates for such treatments.