THE DETECTION and evaluation of pancreatic disease in patients has always been difficult. The symptomatology of such patients is often vague and nonspecific. The anatomic position of the pancreas is such that physical examination of the patient with pancreatic disease usually provides scant information regarding the structure and function of the pancreas. Much reliance has had to be placed upon the laboratory examination to detect pancreatic disease. Many pancreatic function tests have been introduced in the past. Most of these are indirect measurements of pancreatic function. Direct measurement of pancreatic function can be obtained by collecting pancreatic juice through a duodenal tube after stimulation by secretin. However, this test is time-consuming, subject to mechanical difficulties, and tedious for the average clinician. Hence, its use is confined to a small number of large medical centers.
In 1954 Althausen and Uyeyama 1 introduced the starch tolerance test for the detection of