An Analysis on the Amount of Excreted Pancreatic Juice after Pancreatoduodenectomy

Jung, Dong Hwan; Hwang, Shin; Lee, Sung Gyu

Abstract

BACKGROUND/AIMS: There has been lack of data on the secretion of the pancreatic juice after pancreatoduodenectomy. Thus, surgeons have difficulties in predicting the clinical sequences of pancreaticojejunostomy leakage or other pancreatic surgery. METHODS: This study employed 15 patients who underwent pylorus-preserving pancreatoduodenectomy (PPPD) with total external drainage of the pancreatic duct from January 2000 to June 2001. RESULTS: These patients were divided into the normal pancreas group (n=11) and chronic pancreatitis- accompanied group (n=4). Excretion of pancreatic juice was suppressed in a few days after PPPD. Then, it gradually increased and became constant at the postoperative day 4. The amount of excreted pancreatic juice in the normal pancreas group was 229 +/- 99, 85~385 (mean, range) mL/day at the postoperative day 7 before the initiation of oral intake, and was increased to 314 +/- 222, 110~910 (mean, range) mL/day at the 7th day after the initiation of food intake. The usage of octreotide during early fasting period had no influence on the excretion of the pancreatic juice in the normal pancreas group. CONCLUSIONS: We observed the real amount of secreted pancreatic juice after PPPD. These data may be helpful to interpret and manage the postoperative conditions such as pancreatic leakage or pancreatic exocrine insufficiency.