Summary:
The author sumarizes in the submitted review diagnostic possibilities of early stages of chronic
pancreatitis. He evaluates from that aspect possibilities of common imaging methods (ultrasonog-
raphy, commputer tomography, endoscopic retrograde cholangiopancreatography) and endosco-
pic ultrasonography (EUS). Evaluation of the secretory exocrine capacity by means of the
secretin-cerulein test. Although the method is demanding from the aspect of routine diagnosis, it
is a method with comparable sensitivity and perhaps even greater specificity than ERCP.Other
tests of exocrine pancreatic secretion are not sufficiently sensitive to be used for this diagnosis.
Among imaging methods ERCP which is still cansidered the gold standard, evaluates even subtle
changes in the efferent system.Endoscopic ultrasonography visualizes rather dicrete changes of
the parenchymatous structure, areas of fibrosis and oedema ,or changes in the echogenicity of the
duct wall.
At present in the diagnosis of early stages of chronic pancreatitis most probably a combinatiom of
the method evaluating the exocrine secretory capacity of the pancreas and sensitive imaging
methods (ERCP) will be most satisfactory.Further studies will show whether and when EUS could
replace ERCP.
Key words:
Chronic pancreatitis - Endoscopic ultrasonography - Tests of exocrine pancreatic
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