Postoperative evaluation of the exocrine function of the pancreas after pancreaticoduodenectomy

The exocrine function of the residual pancreas of eight patients who underwent pancreaticoduodenectomy was studied with the 131I-triolein absorption test and by 75Se-selenomethionine scintiscanning. In six patients, a pancreaticojejunostomy was performed, while in the other two patients, the pancreatic duct of the residual pancreas was ligated. The fecal 131I-triolein excretory rate in the duct ligation group was more than 50 per cent, while, in all but one patient in the duct anastomosis group, it was less than 10 per cent. Pancreatic scintiscanning in the duct ligation group was negative before and after operation. All of the patients with anastomosis of the duct had an image of the pancreas before operation. However, postoperatively, scintiscanning of the pancreas was negative in two patients and became negative late in the postoperative period in four others without any decline of fat absorption. The cause for this postoperative change in scintiscanning of the pancreas and the discrepancy of this finding with that obtained with the 131I-triolein absorption test remains to be studied.