Plasma secretin levels in total pancreatectomy and pancreaticoduodenectomy.

The secretory response of plasma secretin to intrajejunal acid was measured in 11 patients who underwent total pancreatectomy and eight with pancreaticoduodenectomy. In cases of pancreaticoduodenectomy, the secretory response of plasma secretin was well maintained, but in those with total pancreatectomy there was a significantly impaired secretory response of plasma secretin. Among patients with total pancreatectomy, those with Billroth II type anastomosis showed a significantly impaired response compared with those with Billroth I type anastomosis. Thus biliary secretion is more impaired in patients with total pancreatectomy than in those with pancreaticoduodenectomy. To improve the impaired biliary secretion after total pancreatectomy, Billroth I type anastomosis for reconstruction procedure of the alimentary tract appears to be more feasible. In the case of the major pancreatectomy, much attention should be given biliary secretion and such may decrease the possibility of occurrence of ulcer at the anastomosis and improve the digestion-absorption of fat.