Pressure of papillary sphincter zone and pancreatic main duct in patients with chronic pancreatitis in the early stage.

We measured pressures of the papillary sphincter zone and pancreatic main duct endoscopically in 20 control subjects and in 38 patients with chronic pancreatitis without papillary stenosis, including 19 cases believed to be in the early stages of chronic pancreatitis. There was no significant difference between control subjects and patients with chronic pancreatitis without papillary stenosis in the motility of the sphincter of Oddi. The pancreatic main ductal pressure was significantly higher in the patients in the early stage of chronic pancreatitis (35.7 +/- 9.1 mm Hg (mean +/- SD) in patients suspected of having chronic pancreatitis and 44.9 +/- 20.4 mm Hg in minimal-change chronic pancreatitis) than in the controls (16.2 +/- 8.7 mm Hg). The viscosity of pure pancreatic juice of patients with chronic pancreatitis (5.0 centi-Poise (cP] in the basal secretory phase was significantly higher than that of the controls (1.32 cP). These data suggest that endoscopic measurement of pancreatic ductal pressure is useful for diagnosis of the early stages of chronic pancreatitis.