FAT-ABSORPTION AND GASTROENTERIC PH PROFILE IN POSTSURGICAL PANCREATIC INSUFFICIENCY - ROLE OF THE ASSOCIATION OF H-2-RECEPTOR ANTAGONISTS WITH PANCREATIC-ENZYMES

The complete control of steatorrhea in postsurgical exocrine pancreati c insufficiency is difficult. The aim of this study was to evaluate th e effect of the association of ranitidine with pancrelipase on fecal f at excretion in patients who had undergone a pancreatoduodenectomy wit h suppression of the exocrine pancreatic secretion by Neoprene injecti on. Ten patients were studied 1 year after surgery. Steatorrhea was me asured as an integrated test of 3-day stools, while patients were kept on a diet of 100 g lipid/day, with their usual enzyme supplementation therapy (16,050 USP units of lipase/meal). A basal 24-h gastroenteric pH profile was also obtained. In the following month, patients had ra nitidine (150 mg twice a day) in addition to pancrelipase. Then steato rrhea and gastroenteric pH were reassessed. Mean fecal fat was 26.9 (S D 13.7) g/day without ranitidine and 30.5 (SD 13.9) g/day during combi ned treatment. Body weight and nutritional parameters did not show any significant variation after ranitidine administration. Even in the ab sence of ranitidine, postprandial gastroentefic pH values were always >4; the H-2-receptor antagonist only reduced fasting gastric acidity. In conclusion, the gastroenteric pH and fecal fat determinations showe d that ranitidine is not useful in patients with total postsurgical ex ocrine pancreatic insufficiency.