ASSESSMENT OF POSTOPERATIVE DIGESTIVE FUNCTION AFTER PANCREATICO-DUODENECTOMY - A COMPARISON OF RECONSTRUCTION TECHNIQUES

Background/Aims: Malabsorption is a frequent complication following pa ncreatico-duodenectomy (PD) for pancreatic carcinoma. Gastrojejunostom y followed by Billroth I type of reconstruction (PD III) has been adva nced to prevent this disorder. We compared postoperative digestion and absorption determined by I-131-triolein, D-xylose and pancreatic func tion diagnostant (PFD) after extensive PD followed by one of two recon structive procedures. Material and Methods: Postoperative digestive an d absorptive functions in patients operated by Child's method (PD II) were compared with patients in whom the stomach emptied proximal to th e pancreas and bile duct (PD III). Results: The absorption of D-xylose was significantly higher (1.24+/-0.36 g vs. 0.72+/-0.21 g) in the PD III group. No difference was noted in pancreatic endocrine secretion b etween the two groups. Biliary scintigraphy revealed increased bile se cretion. in She PD III group. Conclusions: These results suggest that PD III is superior to PD II following extensive PD.