Structure and function in noncalcific pancreatitis.

A group of 47 carefully assessed patients with noncalcific pancreatitis was studied with ERCP and the secretin pancreozymin pancreatic function test (PFT). A simple scoring system was constructed for each of the PFT indices to create a PFT score for each patient and four grades of ERCP abnormality were documented, from minimal to gross. A simple pancreatic pain score was constructed to allow for the inclusion of patients with classical pancreatic pain in the absence of acute attacks associated with an elevated serum amylase. In general there was a correlation between the degree of structural change and functional impairment, with patients with the worst pancreatic function having the grossest ERCP changes. ERCP was abnormal in 45 of the 47 patients (96%) and the PFT in 34 of the 47 (72%). However, there were some marked discrepancies between the two methods, in particular two patients with normal function in the presence of gross structural changes. ERCP proved to be the more sensitive diagnostic technique than the PFT in this group of patients.