Aim: To ascertain correlations between pancreatic secretion disturbances and stage and complications of chronic pancreatitis (CP).
Material and methods: The examination covered 81 CP patients (32 females, 49 males, mean age 55.9 +/- 1.8 years). Alcohol pancreatitis (AP) was diagnosed in 52 of them, biliary pancreatitis--in 29, complicated pancreatitis--in 25 patients. The control group consisted of 22 patients without symptoms of gastrointestinal disease.
Results: By the results of clinical, device, laboratory and morphological tests we recognize 3 variants of CP course. Variant A: duration under 5 years, distinct pain syndrome, pancreatic fecal elastase (E-1) level insignificantly decreased, elevated blood levels of acetylcholine (Ac), serotonin (5-NT), cholecystokinin (CCK), secretin is subnormal. Pancreatic tissue is inflamed and swollen. Variant B: duration 5-10 years, E-1 under 100 mcg/g, moderate pain syndrome, prevalence of 5-NT as a stimulator of pancreatic secretory activity. CCK is high and secretin is low. Further progress of fibrous changes by ultrasound investigation, abdominal CT leads to calcinosis in pancreatic tissue. Variant C: duration 10 years and longer, weak pain syndrome, further rise of 5-NT concentration, decompensation of regulatory mechanisms of secretory pancreatic activity, CCK is high, secretin is subnormal.
Conclusion: Changes in correlations between neuromediators and hormones in CP reflect adaptation aimed at retension of secretory pancreatic activity in significant fibrous changes of pancreatic tissue.