[Comparison of three indirect pancreatic function tests in severe chronic pancreatitis--personal observations]. / Porównanie wartosci trzech posrednich testów czynnosciowych trzustki w zaawansowanej postaci przewleklego zapalenia tego narzadu-doswiadczenia wlasne.

The aim of the presented study was a comparative evaluation of the three indirect pancreatic function tests: pancreolauryl-test (PLT), NBT-PABA test and faecal chymotrypsin (CH) efficacy in detecting pancreatic exocrine function impairment in advanced chronic pancreatitis (acp). 30 patients with severe chronic pancreatitis (marked structure changes in ultrasound and CT following Cambridge criteria) confirmed by abnormal secretin-cerulein test (SCT) and 10 healthy controls underwent PLT, NBT-PABA and CH tests. The degree of pancreatic function impairment in SCT was classified following Malfertheiner into 3 subgroups: 1-mild, 2-moderate and 3-severe. All the indirect pancreatic function test were performed using commercially available kits (Temmler-Werke for PLT, Hoffman-La Roche for NBT-PABA and Boehringer Mannheim for CH) according to manufacturer instructions. PLT revealed changes in 27 (0.9), NBT-PABA-in 25 (0.83) and CH-in 22 (0.73) patients with acp. On the other hand those test have shown normal pancreatic function: PLT-in 0.9, NBT-PABA-in 0.7 and CH-in 0.8 in control group. The sensitivity of those test was increased up to 0.94 (PLT and NBT-PABA) and up to 0.88 (CH) and in the subgroup of severely impaired pancreatic function test in SCT. The concomittant use of two indirect pancreatic function tests caused increase of sensitivity up to 0.93. Our results suggest that with PLT, NBT-PABA and CH impaired pancreatic function may be succesfully recognized in advanced chronic pancreatitis, in particular, when two of them are applied concomittantly.

[Diagnosis of diabetes mellitus and disorders of glucose tolerance in patients after acute pancreatitis]. / Wykrywanie cukrzycy i uposledzonej tolerancji weglowodanów u osób po przebytym ostrym zapaleniu trzustki.

The study aimed at evaluating an incidence of diabetes mellitus and carbohydrate tolerance disorders as well as insulinemia in patients with the history of the acute pancreatitis. Baseline glycemia was determined in 50 patients with a history of the acute pancreatitis and in 15 healthy individuals (aged between 18 and 65 years). Blood sugar was then determined 30, 60, 90 and 180 minutes following loading with 75 g of glucose. Fasting insulinemia and that following loading with 75 g glucose were determined at the same time period. Diabetes mellitus was diagnosed in 6 patients (12%) whereas carbohydrate tolerance in 4 patients (8%). A decrease in insulin response to carbohydrates was noted in 36 patients (72%) with a history of the acute pancreatitis in comparison with the control group. The obtained results suggest that the acute pancreatitis significantly decreases endocrine functioning of the pancreas. Therefore, metabolism of carbohydrates should be checked particularly in the individuals with a history of the acute pancreatitis without the symptoms of both diabetes mellitus and sugar tolerance disorders but with the signs of decreased insulin response to carbohydrates.