Physiologic observations upon a partial pancreatic fistula following gastrectomy

1. 1. The secretion from a pure pancreatic fistula which followed subtotal gastrectomy was studied using a variety of drug and gastrointestinal stimuli. 2. 2. The volume output and baseline chemical composition of pancreatic juice following gastrectomy was found comparable to that reported for fistulas not associated with this alteration in gastric physiology. 3. 3. Changes in volume, electrolyte, enzyme and pH levels following the administration of various physiologic stimuli were compared with baseline values, and with similar results recorded in the literature. 4. 4. Diversion of gastric contents from the duodenum to the jejunum by gastrojejunostomy did not appear to alter the normal volume response from the pancreas when secretin or agents which initiate the release of secretin were administered. 5. 5. Our results suggest that a differentiation between volume and electrolyte stimulation (secretin effect) and enzyme stimulation (pancreozymin effect), previously demonstrated in experimental animals, also exists in man. 6. 6. Billroth II gastrectomy did not appear to alter either pancreatic or digestive function to any significant degree in this patient.