THE CHANGES IN THE PANCREATIC FUNCTION AFTER TOTAL COLECTOMY AND ILEO-RECTAL BYPASS

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Twenty mongrel dogs were divided into two groups. Total colectomy was performed on one group and ileo-rectal bypass was performed on another group. For each group, exocrine pancreatic function (PS test under the direct canulation method), bile output and gastro-pancreatic endocrine function (measured by release of gastrin, glucagon and insulin under infusion of L-arginine, and by glucose tolerance test) were studied before and after the operations. Both the volume and the bicarbonate concentration of pancreatic juice decreased significantly one month and three months after total colectomy. The total amylase output of pancreatic juice tended to decrease one month after total colectomy, but it returned to pre-operative levels three months after the operation. And one month after total colectomy, both the serum gastrin levels and the gastrin responses to the intravenous infusion of L-arginine were elevated, but no detectable changes were found in pancreatic endocrine function.Although a similar type of transient diarrhea occurred in both colectomy and bypass groups, no significant changes in pancreatic function and gastrin release were shown one month after ileo-rectal bypass.Not only the decrease in absorptive area, but also pancreatic exocrine disturbance as well as gastric hypersecretion must be taken into consideration in patients with total colectomy.
財団法人日本消化器病学会の論文