Abstract
A slight and transient increase in the amylase level is believed to be frequently observed in the relatively early stage of chronic pancreatitis. To elucidate the morbidity of early-stage chronic pancreatitis, we selected 11 patients with mild hyperamylasemia and eight control patients with normal amylase levels, who had undergone pancreatic biopsy for various reasons, from a series of patients who had been undergone pancreatic biopsy under laparoscopic observation. The amylase level, diagnostic image findings in terms of ultrasonography, CT, endoscopic retrograde pancreatography and laparoscopic findings in these patients were compared with histological findings. No histological differences were noted between the mild hyperamylasemia and control groups, suggesting that it is difficult under the present conditions to screen for chronic pancreatitis in the early stage from the aspect of mild hyperamylasemia alone. A very close correlation was noticed between the definite diagnostic imaging and the histological findings. However, patients with a suspi-cious diagnosis or who were evaluated as showing referential findings on diagnostic imaging presented approximately normal tissues histologically. Thus, no finding of an initial image of chronic pancreatitis was obtained. Furthermore, no clear correlation was shown between the macroscopic findings of the pancreas obtained by laparoscopy and the histological findings. While accepting the fact that the morbidity of chronic pancreatitis should be elucidated on the basis of histological findings, it is also clear that multimodal diagnosis involving pancreatic biopsy under laparoscopic observation should be further developed.
