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Pancreatic digestive function after subtotal gastrectomy--evaluation by an indirect method.

P Malfertheiner, U Junge, H Ditschuneit

    Hepato-Gastroenterology
    |August 1, 1984
    PubMed
    Summary
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    Billroth (BII) subtotal gastrectomy patients often experience maldigestion, with 75% showing abnormal results on the fluorescein-dilaurate (FDL) test. This test indicates impaired pancreatic function after gastric surgery, but isn't specific for chronic pancreatitis.

    Area of Science:

    • Gastroenterology
    • Digestive Physiology
    • Surgical Outcomes

    Background:

    • Billroth (BII) subtotal gastrectomy is a surgical procedure affecting digestive function.
    • Assessing pancreatic exocrine function post-gastric surgery is crucial for understanding patient outcomes.
    • The fluorescein-dilaurate (FDL) test is an oral pancreatic function test.

    Purpose of the Study:

    • To investigate the digestive function in patients following Billroth (BII) subtotal gastrectomy.
    • To evaluate the utility of the fluorescein-dilaurate (FDL) test in assessing pancreatic maldigestion after gastric surgery.

    Main Methods:

    • The study involved 24 patients who underwent Billroth (BII) subtotal gastrectomy and gastrojejunostomy.
    • An oral pancreatic function test using fluorescein-dilaurate (FDL) as a substrate was administered.

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  • Results were compared to those of healthy controls and patients with chronic pancreatitis.

    • Main Results:

    • 75% of patients after Billroth (BII) surgery exhibited maldigestion via the FDL test.
    • The mean FDL-ratio in BII patients was significantly lower (21.6%) compared to healthy controls (62.2%).
    • Abnormal FDL test results were observed in patients with and without chronic pancreatitis, and no correlation with symptoms like dumping or diarrhea was found.

    Conclusions:

    • The fluorescein-dilaurate (FDL) test indicates impaired pancreatic digestion in a majority of patients post-Billroth (BII) subtotal gastrectomy.
    • Abnormal FDL test results after gastric surgery suggest delayed enzyme secretion or poor intraluminal mixing.
    • The FDL test is not a specific diagnostic tool for chronic pancreatitis in patients who have undergone gastric operations.