EFFECT OF DUODENUM-PRESERVING RESECTION OF THE HEAD OF THE PANCREAS ON ENDOCRINE AND EXOCRINE PANCREATIC FUNCTION IN PATIENTS WITH CHRONIC-PANCREATITIS

BACKGROUND: Chronic pancreatitis leads to progressive destruction of p ancreatic parenchyma affecting exocrine and endocrine function. We pro spectively evaluated the effect of duodenum-preserving resection of th e head of the pancreas on pancreatic function. METHODS: Exocrine and e ndocrine function were measured in a combined test including (1) urina ry PAPA recovery; (2) plasma glucose, glucagon, and C-peptide response s; and (3) plasma pancreatic polypeptide response. Nineteen patients w ere included, RESULTS: Compared with the preoperative state, plasma gl ucose levels did not increase postoperatively, Plasma C-peptide levers were reduced postoperatively but the difference was not significant. The percentage of insulin-dependent patients did not increase after op eration (32% versus 32%). Glucose tolerance improved in 4 patients and deteriorated in 3 patients. Postoperative basal and-meal stimulated p lasma pancreatic polypeptide levels were significantly reduced. Postop erative urinary PAPA recovery was not significantly different from pre operative values. CONCLUSIONS: Neither exocrine nor endocrine pancreat ic function are negatively influenced by duodenum-preserving pancreati c head resection. (C) 1997 by Excerpta Medica, Inc.