LEADING ARTICLE
A perspective on the use of tubeless pancreatic function tests in diagnosis
| The first 150 words of the full text of this article appear below. |
For many years, gastroenterologists have searched for the holy
grail of pancreatic function tests
the tubeless test. The quest is to
find an accurate, simple, easy, sensitive, and specific non-invasive
test that can detect mild to moderate decreased exocrine function in
patients without signs of pancreatic disease on imaging tests. Such a
test would increase the possibility of diagnosing early chronic
pancreatitis and perhaps pancreatic cancer as pancreatic function may
decrease in pancreatic diseases before imaging tests become abnormal.
However, tests based on decreased exocrine function can never be one
hundred per cent sensitive for the diagnosis of chronic pancreatitis;
even some patients with pancreatic calcification, a recognised hallmark
of advanced chronic pancreatitis, have normal exocrine
function.1
Generally, modern tubeless tests satisfactorily distinguish pancreatic
from non-pancreatic malabsorption as they are sensitive indicators of
pancreatic disease when pancreatic function is severely decreased.
However, for pancreatic insufficiency to be severe enough to
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