[Clinical relevance of immunochemical determination of pancreatic lipase in chronic pancreatitis].

The determination of basal pancreatic serum enzymes is of little value in the diagnosis of chronic pancreatitis. The organ specificity of a recently introduced immunochemical method of determining pancreatic lipase is guaranteed. The diagnostic value of the basal and stimulated serum-lipase determination by the immunochemical assay in chronic pancreatitis was investigated on 84 patients and controls. In 46 patients with chronic pancreatitis the serum increase of pancreatic lipase after secretin stimulation (1 U/kg) was significantly (P less than 0.01) higher than the pancreatic lipase increase in patients with non-pancreatic intestinal disorders and in healthy controls. Patients with chronic pancreatitis deserve to be classified in subgroups, according to the degree of the exocrine pancreatic insufficiency established by means of the secretin-ceruletide test. Of the patients with chronic pancreatitis and a slight to moderate exocrine pancreatic insufficiency 87% show an abnormal serum pancreatic-lipase increase and differ significantly (P less than 0.01) from patients with severe exocrine insufficiency who exhibit an increase of the pancreatic serum lipase only in exceptional cases. Specificity is limited, since an abnormal serum lipase increase after stimulation is found in 20% of controls.