Short-term and long-term pancreatic exocrine and endocrine functions afterpancreatectomy

Exocrine and endocrine functions of the pancreas were assessed in 44 Japane se patients who underwent pancreatic head resection. Functions were analyze d comparing levels before surgery, at a short-term follow-up (<2 months), a nd at a long-term follow-up (12-31 months), The N-benzoyl-L-tyrosyl-p-amino benzoic acid (BT-PABA) excretion test, fasting blood sugar (FBS) level, and oral glucose tolerance test (OGTT) were used to determine pancreatic funct ion. The patients were divided into three groups according to the size of t he main pancreatic duct: group 1, 15 patients with a normal sized duct (les s than or equal to 3 mm); group 2, 20 with a moderately dilated duct (>3 mm , <10 mm); and group 3, 9 with a markedly dilated duct (greater than or equ al to 10 mm). The mean BT-PABA value (6-hr urinary PABA recovery rate) in g roup showed no change during the postoperative period. In contrast, the BT- PABA values in groups 2 and 3 had dropped by the short-term follow-up and r eturned to the preoperative level by the long-term examination. FBS and 120 -min OGTT levels were not different between the three groups preoperatively . Although these values showed no change in all the three groups at the sho rt-term measurements, the FBS in group 3 and 120-min levels in all the thre e groups had increased at the long-term. These findings suggest that exocri ne pancreatic function shows a short-term deterioration in patients with a dilated pancreatic duct but recovers to the preoperative level over the lon g term after pancreatic head resection. Endocrine insufficiency, however, m ay occur at a long-term point after surgery irrespective of the preoperativ e pancreatic ductal dilatation.