A study of exocrine pancreatic function by pancreatic function diagnostant (PFD) on cancer of pancreas and biliary tract.

Since 1976, the authors administered the test meal PFD to patients mainly with pancreatic diseases in order to know the changes in the exocrine function of the remaining part of the pancreas. In the present study, investigation was made on the usefulness of PFD in the cases undergoing surgery for pancreatic and biliary cancers, according to the sites of cancers. Urinary P ABA in 6-hour urine· showed low levels in the cases of pancreatic head cancers and ampullary cancers, and their excretion patterns showed a delayed excretion type in the cases other than extrapancreatic biliary cancers. In the resectable cases, the 6-hour urine level of P ABA was significantly improved within 12 months of surgery compared with that before surgery (p<O. 01). Their excretion patterns showed the high peak levels in 2 hours and decreased sharply thereafter. When the PFD is administered out, it seems to be useful for the analysis of the excretion patterns as well as 6-hour urine levels in order to predict the conditions the pancreas .duct and the recovery of the pancreatic exocrine function. 19 INTRODUCTION It is very useful, in many aspects, to know the pancreas functions before and after surgical operations because the disease in the bile duct and the pancreas are often complicated with the impairment of the functions of the pancreas as well as those of the liver. The pancreozymin-secretin test (PS test)3l has so far been believed to be the most reliable way to examine the activity of the pancreas exocrine function. However, since this test utilizes the cannulation method requiring complicated techniques, the test has been carried out mainly before operations. A synthetic peptide, N-benzoyl-L-tyrosil-paraamino-benzoic acid (BTPABA), described first by Imondi et al. 2) in 1971 has been widely usecl as a pancreatic function diagnostant {PFD). .Altho_ugh there still remain sorhe problems to be. solved, the PFD can easily be applied to patients even after operations. Since 1976, the authors4) have carried out trials on the PFD. mainly in the cases of pancreatic diseases. Descripti~n s are made in the present papers on the PFD for the cases with surgical operations for pancre~tic and biliary cancers. . . . . ·MATERIALS AND METHODS The sites of cancers in our cases were classified according to the criteria for the management of pancreatic and biliary cancers. For convenience' sake, cancers in the lower biie duct described in the criteria for management of pancreatic and biliary· cancers were defined as. intra pancreatic biliary cancer. and those in *) Yc.:E *· B3${i.[:1(, ~ff:J'Cr\~B. Vrl*Jt~. l*EE:J'Ct!t #tiHaPE, YG.:E m, l[llffit1il~ : )Vf'.Mij, )lli)gMIJF~:.:rovt Q Pancreatic Function Diagnostant (PFD) ~t J:: 0 Wf'.;7})tf&'.1~~~0)~lf.J