Relationship of pancreatic function and glucose tolerance to the morphology of the pancreatic ductal system as revealed by ERCP

Abstract

A series of 226 patients with suspected pancreatic disease examined with ERCP, included 130 patients with normal ductal morphology (group I), 24 with 1-2 smooth narrowings of the main duct of the pancreas (group II), 20 with ectatic small branches (group III), 22 with an irregular main duct and ectatic small branches (group IV), and 30 patients with other findings in the pancreatogram. Pancreatic exocrine function was measured in 140 patients using the secretin test. The mean value of the maximal bicarbonate concentration was significantly (p less than 0.001) lower in the patients with severe ductal changes than in those with a normal pancreatogram. In addition, the number of patients with impaired exocrine function was significantly higher in group IV than in group I. The other groups did not differ significantly. A two-hour glucose tolerance test was done on 104 patients in addition to which 19 patients had overt diabetes. The number of patients with abnormal glucose tolerance was significantly higher in group IV (60%) than in group I (27.5%). The mean blood sugar value was also higher after one hour in group IV than in group I. The patients in the other groups did not differ significantly with regard to glucose metabolism. An almost significant negative correlation was found between the maximal bicarbonate concentrations and the one-hour blood glucose values (p less than 0.05).