PANCREATIC INTERSTITIAL PH IN HUMAN AND FELINE CHRONIC-PANCREATITIS

Background & Aims: Advanced chronic pancreatitis is associated with a reduction in pancreatic blood flow. To determine the physiological sig nificance of this decrease, pancreatic interstitial pH was measured in a model of obstructive chronic pancreatitis in cats and in patients w ith chronic pancreatitis. Methods: In cats, pancreatic interstitial pH and blood flow were measured serially under basal conditions and afte r secretory stimulation as chronic pancreatitis evolved. Basal pancrea tic interstitial pH was also measured in patients undergoing an operat ion for chronic pancreatitis or periampullary cancer (controls). Resul ts: In normal cats, pancreatic interstitial pH was 7.41 +/- 0.01 and b lood flow was 124 +/- 12 mL . min(-1) (100 g pancreas(-1)). With the e volution of chronic pancreatitis, interstitial pH and blood flow progr essively decreased to 7.21 +/- 0.04 (P < 0.007) and 75 +/- 11 (P < 0.0 07), respectively. From l tb i weeks, secretory stimulation reduced pa ncreatic interstitial pH and blood flow further, but as secretory func tion was lost, this effect disappeared. In patients with chronic pancr eatitis, the interstitial pH was lower (7.02 +/- 0.06) than in control s (7.25 +/- 0.04; P < 0.05). Conclusions: These observations are consi stent with the hypothesis that, in chronic pancreatitis, acidic metabo lites associated with pancreatic secretion accumulate within the pancr eas, probably because of impaired blood flow.