Clinical and experimental study of pancreatic exocrine function after pancreaticoduodenectomy for periampullary carcinoma.

The residual pancreatic exocrine function before and after pancreaticoduodenectomy (PD) for periampullary carcinoma was studied clinically as well as experimentally. In clinical instances (n = 35), the N-Benzoyl-L-Tyrosil-p-Aminobenzoic Acid test (BTPABA test) before and within two months after PD revealed reduction of the function compared with those in the control study. However, the test result one year after PD was improved compared with those before and within two months after operation, without differences from that of the control group. In new canine PD models in which drainage of the pancreatic duct, 50 per cent pancreatectomy and duodenojejunectomy were performed after three months of pancreatic duct obstruction, fibrosis surrounding the pancreatic duct was disclosed. However, the results of examination five months after PD revealed a milder degree of pancreatic fibrosis without aggravation of the lesion. The aforementioned findings indicated that the exocrine pancreas before PD was impaired due to obstructive pancreatitis and that the postoperative pancreatic function was well preserved at the level close to that in the control group even after approximately 50 per cent resection of the pancreas, if pancreatic duct drainage was effectively performed.