EXOCRINE PANCREATIC FUNCTION IN THE EARLY PHASE OF HUMAN ACUTE-PANCREATITIS

Background: Little is known about exocrine pancreatic function during human acute pancreatitis. We aimed to evaluate interdigestive exocrine pancreatic secretion and pancreatic polypeptide (PP) release during t he early phase of acute pancreatitis in humans. Method: Eight patients with acute pancreatitis (six biliary, one alcoholic, and one idiopath ic acute pancreatitis) were studied within 72 h from the onset of symp toms. Four patients had necrotizing and four had edematous acute pancr eatitis. Normal values were obtained from 26 normal subjects matched b y sex and age. Interdigestive pancreatic secretion was studied by a du odenal intubation perfusion technique. Enzyme output was calculated fo r consecutive 15-min periods over 3-4 h and expressed as units per hou r within a secretion cycle and units per hour around a secretion peak. Plasma PP concentrations were measured by radioimmunoassay in 15-min intervals. Results: All variables studied were similar in patients wit h acute pancreatitis and in controls. PP release in acute pancreatitis was maintained in a normal cyclical pattern closely related to the se cretory cycles. Conclusions: Interdigestive exocrine pancreatic secret ion in the early phase of mild to moderate acute pancreatitis in human s remains within the normal range. This finding provides a rational ba sis for early therapeutic inhibition of pancreatic secretion in human acute pancreatitis.