Exocrine pancreatic function tests.

Despite the development in the last two decades of new imaging techniques for the detection of pancreatic disease, discrepancies between functional and morphological findings can be remarkable. Pancreatic function tests may aid in the detection of disease at an earlier stage in some patients and can assess the degree of functional damage which is helpful in assessing patients for supplemental therapy. While direct intubation methods are invasive and time consuming, they remain the gold standard against which the other investigations have to be assessed. An indirect test, such as the pancreolaural test, has been shown to be a useful addition to ultrasound for the screening of pancreatic disease. Pancreatic markers and radioisotope methods have failed to live up to early promise, but fecal tests can be used effectively to monitor enzyme replacement. A judicious combination of pancreatic function tests and imaging techniques may be able to rationalize investigation and treatment of pancreatic disease.