Exocrine and Endocrine Pancreatic Secretion Following Pancreatic Resection

Abstract

The Whipple procedure, i.e. a partial duodeno-pancreatectomy, is the gold standard in the operative treatment of cancer of the pancreatic head aiming at cure [15, 17]. In spite of recent advances in operative techniques and postoperative intensive care, perioperative morbidity and mortality remain high [17]. Tryptic activity of the pancreatic remnant may lead to postoperative pancreatitis or breakdown of the anastomosis with fistula formation. It is therefore necessary to look for a therapeutic principle which inhibits the exocrine pancreatic secretion before, during, and after surgery. Atropin, aprotinin, glucagon, somatostatin, and calcitonin have been under investigation, but results have not been very satisfactory and remain under discussion [7, 8, 13]. Numerous studies report on the effects of somatostatin on the endocrine and exocrine pancreatic function [2, 3, 14]. With respect to the clinical course after pancreatic surgery, positive results have been reported with the administration of somatostatin [7, 8]. However, almost nothing is known about the exocrine and endocrine function of the pancreatic remnant after a Whipple procedure under somatostatin.