J.Jpn. Surg. Soc.. 85(10): 1332-1343, 1984

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Original article

THE INFLUENCE OF OBSTRUCTIVE JAUNDICE ON THE WOUND HEALING OF PANCREATICO-JEJUNOSTOMY WITH REFERENCE TO THE FUNCTION OF THE PANCREAS AS ASSESSED BY GLUCOSE TOLERANCE AND PANCREOZYMIN-SECRETIN TEST

Mongrel dogs jaundiced by ligation of the common bile duct for 3-week period were submitted to simultaneous biliary drainage and pancreatico-jejunostomy and sacrificed on day 1, 3, 5, 7, 14 and 30 after operation. The wound healing process of the anastomotic site was evaluated in terms of microvaculature, histopathological findings, pancreatic hydroxyproline content, incidence of anastomotic leakage and bursting strength of the anastomotic site. Pancreatic function were assessed by intravenous glucose tolerance and pancreozymin-secretin test.
Acute inflammation at the anastomotic site was severer in the jaundiced pancreas on day 1,3 and 5, respectively, than in sham operated controls. The group of dogs with serum bilirubin levels ranging 1 to 5mg/dl (mean 3.2) tolerated significantly higher bursting strength (p＜0.01) with less incidence in anastomotic leakage (p＜0.01) as compared to the group of dogs with serum bilirubin higher than 5mg/dl (mean 7.6). The data demonstrate that pancreatico-duodenectomy is primarily indicated to the interic patients after serum bilirubin is decreased lower than 5mg/dl. Exocrine function of the pancreas showed no significant differences between the control and jaundiced dogs, but glucose tolerance in jaundiced dogs was decreased without appreciable changes in serum insulin levels.

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