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There is no effective serologic parameter to distinguish different types of pancreatitis now. To distinguish between acute pancreatitis (AP) and acute exacerbations of chronic pancreatitis (CP) and to determine whether fibrosis occurs in CP, we evaluated the ability to produce white blood cells (WBCs), the neutrophil-to-retinol-binding protein (RBP) ratio (called the WNR), the product of the gamma-glutamyl transpeptidase (GGT) level, and the 5'-nucleotide-to-RBP ratio (called the GNR). We evaluated the newly proposed difference index R