Clinical significance of fecal chymotrypsin test in chronic pancreatitis. A comparative study of the its value with pancreozymin-secretin test, PFD test, and endoscopic retrograde pancreatography. : A Comparative Study of the Its Value with Pancreozymin-S

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Fecal chymotrypsin test was evaluated on single spot specimens with the new photometric method in 105 healthy subjects, 23 patients with chronic pancreatitis, 6 patients with pancreas carcinoma, and 92 patients with non-pancreatic diseases. The fecal chymotrypsin activities were significantly lower in patients with chronic pancreatitis and pancreas carcinoma than in healthy subjects and patients with non-pancreatic diseases. Especially in patients with calcified pancreatitis and in those with severe changes in pancreatic ducts on ERP findings, fecal chymotrypsin values were markedly low. There were the significant correlations between fecal chymotrypsin activities and maximal bicarbonate concentration, outputs of bicarbonate and amylase in duodenal aspirates by the pancreozymin-secretin (PS) test. Fecal chymotrypsin activity was abnormally low in 61% of patients with chronic pancreatitis, and 90% of patients with apparent pancreatic insufficiency in PS test. On the other hand, the incidence of false positive fecal cymotrypsin test was 28%. It is concluded that the fecal chymotrypsin test in useful for screening of pancreatic diseases and follow-up of chronic pancreatitis, as it is noninvasive and easy to measure.