Standards for the diagnosis of chronic pancreatitis and for the evaluation of treatment.

The diagnosis of chronic pancreatitis should be based on the characteristic case history and a combination of exocrine pancreatic function tests and morphological examinations. For diagnostic purposes, an indirect pancreatic function test may be sufficient when direct tests are not available. Otherwise, and especially for scientific evaluation of chronic pancreatitis, a direct pancreatic function test is necessary. In each patient, an ultrasound examination of the pancreas should be performed and, if inconclusive, also computed tomography. In a symptomatic patient, that is, a patient suffering from relapsing pain attacks, an ERCP examination is indicated. A score for the severity of chronic pancreatitis using symptoms, results of function tests, and morphological examinations should be developed for a world-wide comparison of studies. Treatment results should be reported not earlier than 2 yr after the initiation of conservative treatment or surgery. The evaluation of treatment should be based on a score (also to be developed) making use of symptoms.