Effect of biliary diversion on exocrine pancreas

An experimental study was conducted on the effect of bile diversion on exocrine pancreatic function. Twelve dogs were divided into three groups, one group consisting of a choledochojejunostomy; one, a choledochoduodenostomy, and one, a choledochocholedochostomy. In each group, exocrine pancreatic function was observed before and two months after the operation. With combined secretin and pancreozymin infusion, a significant decrease in the rate of flow, bicarbonate concentration and amylase output was seen only after choledochojejunostomy. The function of the exocrine pancreas was markedly decreased late in the period of stimulation. Contrariwise, no pancreatic dysfunction was noted after choledochoduodenostomy or choledochocholedochostomy. The high incidence of peptic ulcer formation after choledochojejunostomy might be closely connected with the postoperative impairment of exocrine pancreatic function.