S. Miyakawa et al., ESTIMATION OF FAT-ABSORPTION WITH THE C-13-TRIOCTANOIN BREATH TEST AFTER PANCREATICODUODENECTOMY OR PANCREATIC HEAD RESECTION, World journal of surgery, 20(8), 1996, pp. 1024-1029
The aim of this study was to determine if fat absorption is better aft
er pylorus-presenting pancreatoduodenectomy (PPPD) or duodenum-preserv
ing pancreatic head resection (DPPHR) compared with that following pan
creatoduodenectomy with gastrectomy (SPD), provided the patients have
similar pancreatic exocrine function. Fat absorption was studied using
the C-13-trioctanoin breath test in patients who were grouped accordi
ng to the degree of fibrosis of the pancreatic remnant. The latter was
judged by histologically measuring the fibrosis in a transectional we
dge of resected pancreas, We evaluated 11 SPD cases, 25 PPPD cases, an
d 9 DPPHR cases. The C-13 excretion rates and cumulative excretion val
ues following DPPHR or PPPD were significantly better than those follo
wing SPD. The C-13 excretion rates and cumulative values for the patie
nts with > 30% fibrosis of the pancreas were lower than those in patie
nts with < 30% pancreatic fibrosis, regardless of the surgical procedu
re, The cumulative value in the SPD group, however, was lower than tha
t in the PPPD or DPPHR patients with < 30% pancreatic fibrosis. The re
sults suggested that fat absorption following PPPD or DPPHR is superio
r to that after SPD in patients with the same fibrotic area of the pan
creatic remnant and depends on the degree of fibrosis in the pancreati
c remnant.