The clinical value of endoscopic retrograde pancreatography (ERP) was evaluated in 129 patients in whom the chronic pancreatic disease was suspected by clinical and laboratory findings, and in whom ERP as well as pancreatic function tests including Pancreozymin-Secretin test (PS test) were performed. On the basis of findings in pancreatic function tests apart from ERP the patients were referred to three different groups; definite, highly suspicious and slightly suspicious groups. The incidences of abnormal pancreatogram in definite, highly suspicious and slightly suspicious group were 96, 45 and 38 percent, respectively.
Comparison with the pancreatographic findings and results of PS test was made in 12 cases of pancreatic cancer and 21 cases of chronic pancreatitis who were proved by either surgery or clinical criteria of chronic pancreatitis by the Japanese Association for the Study of Pancreatic Disease. The findings of the pancreatograph and the result of PS test were graded to three groups; normal, mild and advanced change. All cases of pancreatic cancer except one having mild change showed advanced change in pancreatographic findings, while the results of PS test were variable. Eight out of 9 cases of chronic pancreatitis who had advanced change in pancreatographic findings showed also advanced change in PS test. On the other hand, advanced change in pancreatographic findings was found in 8 out of 15 cases of chronic pancreatitis having advanced change in PS test, and in one out of 5 cases of chronic pancreatitis having mild change in PS test.
Our results indicate that ERP is more useful in the diagnosis of pancreatic cancer than PS test, however in the diagnosis of chronic pancreatitis the usefulnes of ERP and PS test seems to be similar.