J.Jpn. Surg. Soc.. 80(11): 997-1001, 1979

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Report on the annual meeting

RESIDUAL PANCREATIC FUNCTION FOLLOWING PANCREATICODUODENECTOMY

In a total of 96 cases with carcinoma of the head of pancreas and periampullary region seen in our department since 1965, pancreaticoduodenectomy was performed on 35 cases composed of 13 with carcinoma of the head of pancreas, 10 with carcinoma of the intrapancreatic bile duct and 12 with carcinoma of papilla of Vater. There were two cases of operative mortality (5.7%). In all cases, 50% of the cephalic side of the pancreas was excised, and reconstruction after pancreaticoduodenectomy was archived by a modified Whipple procedure employing duct-mucosal pancreaticojejunostomy.
The residual pancreatic function of those who had survived over one year was studied over time and the changes in CEA were determined.
The exocrine pancreatic function as determined by 131-I-Triolein fat absorption test and PABA based on pancreatic diagnostant was moderately decreased in many cases within three months, after surgery and there were even cases with decreased function after six months, thus the administration of digestive enzymes and the execution of nutritional control are necessary. In cases with survival of two years or more, the values were normal and the state of nutrition was good.
Oral glucose tolerance test and IRI showed abnormal OGTT results prior to surgery in more than 80%, whereas in IRI a response of 90% was obtained. At three months after surgery, abnormal OGTT results had decreased to 50% and IRI was also well maintained.
Determination of CEA over time after surgery showed that cases who had demonstrated values in excess of 10 ng/ml (Z-Gel)had developed local recurrence and died of hepatic metastasis. Thus, CEA plays an important role in the postoperative patient care.

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