Effect of duodenum-preserving resection of the head of the pancreas on endocrine and exocrine pancreatic function in patients with chronic pancreatitis

BACKGROUND: Chronic pancreatitis leads to progressive destruction of pancreatic parenchyma affecting exocrine and endocrine function. We prospectively evaluated the effect of duodenum-preserving resection of the head of the pancreas on pancreatic function. METHODS: Exocrine and endocrine function were measured in a combined test including (1) urinary PAPA recovery; (2) plasma glucose, glucagon, and C-peptide responses; and (3) plasma pancreatic polypeptide response. Nineteen patients were included, RESULTS: Compared with the preoperative state, plasma glucose levels did not increase postoperatively, Plasma C-peptide levers were reduced postoperatively but the difference was not significant. The percentage of insulin-dependent patients did not increase after operation (32% versus 32%). Glucose tolerance improved in 4 patients and deteriorated in 3 patients. Postoperative basal and-meal stimulated plasma pancreatic polypeptide levels were significantly reduced. Postoperative urinary PAPA recovery was not significantly different from preoperative values. CONCLUSIONS: Neither exocrine nor endocrine pancreatic function are negatively influenced by duodenum-preserving pancreatic head resection. (C) 1997 by Excerpta Medica, Inc.