Pancreatic enzyme secretion and pancreatic pseudocysts in patients with chronic pancreatitis

Summary

Conclusions

Pseudocyst contents are not indicative of pancreatic function. We presume that the nonresolving pseudocysts did not resolve because they were noncommunicating. The question of the kinetics of secretion into pancreatic pseudocysts is still unresolved.

Background

Pseudocysts are one of the complications of chronic pancreatitis. We wanted to investigate whether it is of any value to measure enzyme activities (amylase and lipase) in pseudocyst contents, in order to answer the following questions: Is the enzymatic activity:

• 1. Reproducible in consecutive punctures of the same cyst;

• 2. Related to cyst age;

• 3. Indicative for the risk of relapse; and

• 4. Representative of exocrine pancreatic function.

Methods

In a retrospective study we examined 28 patients with chronic pancreatitis complicated with pancreatic pseudocysts.

Results

Reproducibility of enzyme activity in cyst juice in consecutive punctures of the same cyst was poor. We did not observe any correlation between enzyme activity and cyst age defined as the time between two cyst punctures. Enzyme activity in cyst juice was without indication for the risk of relapse. No correlation between enzyme activity and exocrine pancreatic function was found. The pseudocyst contents are not pancreatic juice in the common sense of the word.