The aim: The aim of our study is a critical assessment of usefulness of stool elastase estimation in chronic pancreatitis in clinical practise. Patients and methods: Our study contains 110 patients, 80 from these were suffering from chronic pancreatitis (CP) according to abdominal ultrasound, CAT scan and ERCP. 24 patients were suffering from mild chronic pancreatitis (CPI), 26 patients had moderately severe chronic pancreatitis (CPII) and 28 patients had severe chronic pancreatitis (CPIII) according to Cambridge morphology score. After second evaluation we divided these groups into two parts: 50 patients with mild and moderate severe disease had mild morphology changes of chronic pancreatitis and 28 patients had severe disease and severe morphology findings of CP III group. All patients were investigated for stool elastase by ELISA test sandwich technique (Bioserv comp.) using polyclonal antibodies against human elastase. Cutt-off of the test was 250
/g stool. Results: Average stool elastase value in patients CPIII was statistic significantly lower than in control group (116.2 ± 121.2
g/g resp. 479.2 ± 57.6
g/g, p < 0.0001) and patients CPI group (116.2 ± 121.2
g/g resp. 451.6 ± 95.4
g/g, p < 0.0001) and CPII group (116.2 ± 121.2
g/g resp. 349.4 ± 162.8
g/g, p < 0.0001). Conclusions: Stool elastase estimation is not useful method for diagnosis of mild chronic pancreatitis but successfully sensitive for more serious form of this disease. Repeated investigation of stool test can be a marker of progression of loss of pancreatic function. Investigation of exocrine pancreatic function should be a part of classification of chronic pancreatitis. Stool elastase estimation can differentiate between the presence or absence of pancreatic insufficiency.

        Key words: stool elastase test – chronic pancreatitis – exocrine pancreatic function