The therapeutic effectiveness of a conventional (
Pankreon-Granulat) and an
acid-protected (Kreon) porcine pancreatic
enzyme preparation, and an
acid-stable fungal
enzyme preparation (
Nortase) in the treatment of severe pancreatogenic steatorrhoea was investigated. The study comprised 17 patients with
chronic pancreatitis and
exocrine pancreatic insufficiency with (A) or without (B) a previous Whipple's procedure (B II resection + partial
duodenopancreatectomy). With all three
enzyme preparations, a significant (p less than 0.05) reduction in the total faecal fat excretion/day was achieved. In therapy group A, this reduction was, on average, 58% for Kreon (100,000 U
lipase/day), 67% for
Pankreon-Granulat (360,000 U
lipase/day) and 54% for
Nortase (75,000 U
lipase/day), the respective figures for therapy group B being 58%, 52% and 46% at identical dosages. Thus, in both groups, the effect produced by the conventional porcine pancreatic
enzyme preparation and the
acid-protected porcine or the
acid-stable fungal
enzyme preparation was largely equivalent, although the latter two preparations were administered at only 1/4 of the dosages of the former preparation. On the basis of the respective average reduction in total faecal fat excretion and average number of stools/day, it would appear that in patients with
chronic pancreatitis and prior Whipple's procedure,
Pankreon-Granulat should be administered for
enzyme replacement while in patients with an intact upper gastrointestinal tract, Kreon should be administered, in the treatment of steatorrhoea in
chronic pancreatitis.