[Clinical and experimental studies on pancreatic functions and gastrointestinal hormones after major pancreatectomy]

The present study was undertaken to evaluate the changes of gastrointestinal hormones and pancreatic functions after major pancreatectomy in dogs and human. After more than 92% pancreatectomy in dogs, all dogs developed diabetes mellitus (DM). In these dogs, the remnant pancreas showed poor regeneration rate of 24.0% at 6 weeks, decreased sigma IRI in IV-GTT had not been recovered, pancreatic glucagon response was diminished, pancreatic exocrine function had been declined with increased plasma levels of secretin and CCK, and gastric secretion increased in spite of diminished gastrin response. After 74 to 92% pancreatectomy, 17.6% of dogs developed DM. The dogs with DM had poor pancreatic regeneration rate of 22.7% at 12 weeks, hypersecretion of glucagon and decreased gastric secretion with low plasma concentration of gastrin. On the other hand, in dogs without DM, pancreatic regeneration rate showed 42.7% at 12 weeks, insulin release and pancreatic exocrine function had been recovered well, and plasma CCK levels increased without changes of gastric secretion. In the clinical study, gastric secretion, CCK response and pancreatic endocrine and exocrine functions had been maintained better after pylorus preserving pancreaticoduodenectomy than after conventional pancreaticoduodenectomy.