Chronic pancreatitis: Is pancreatic function testing necessary?

2019-01-29
Miroslav Vujasinovic

References

Löhr JM, Dominguez-Munoz E, Rosendahl J, et al; HaPanEU/UEG Working Group. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol J. 2017 Mar;5(2):153-199. doi: 10.1177/2050640616684695. Epub 2017 Jan 16. Review. PubMed PMID: 28344786; PubMedCentral PMCID: PMC5349368.

Is pancreatic function testing necessary to establish the diagnosis of chronic pancreatitis?

Miroslav Vujasinovic, MD, PhD: If you just follow [the guidelines from United European Gastroenterology], we have a statement that it is important. But the diagnosis of chronic pancreatitis is complex because there are also clinical, radiological, histologic, and laboratory criteria. So if the radiology and endoscopy are inconclusive, then we can help ourselves and patients with a function test. But if we have a patient with a clear diagnosis of chronic pancreatitis and if the patient has clinical symptoms, then I think it is enough to make a diagnosis.

Another problem is harmonization across Europe. There are a lot of countries in Europe and outside Europe that cannot afford some function tests, for example, elastase. This is why we think that the clinicians’ point of view and laboratory [tests] can help us a lot.

In conclusion, it is very nice if we can confirm that, but sometimes it is not necessary.

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