EXPERIMENTAL STUDIES ON THE EXTERNAL SECRETION OF THE PANCREAS WITH SPECIAL REFERENCE TO THE EFFECT OF ITS COMPLETE LOSS BY PERMANENT PANCREATIC FISTULA

Abstract

Total drainage of pancreatic juice by fistula was fatal to a dog in 8 days, producing characteristic metabolic alterations, particularly anhydremia with moderate elevations of urea preceding death. Subtotal pancreatic drainage was without lethal effect on 2 dogs in 14 and 32 days. In a dog with total pancreatic drainage, daily intravenous injection of physiologic NaCl solution prolonged life until the 34th day after operation (juice injected the 14th day), the blood chemistry being unaffected. Of 2 other dogs with pancreatic fistulae, 1 which received dialyzable (crystalloid) fraction of pancreatic juice orally died on the 5th day after operation; the other received non-dialyzable (colloid) fraction of pancreatic juice and died on the 12th day. Of 2 dogs with total pancreatic drainage, 1 was early given non-dialyzable fraction of pancreatic juice by mouth; on the 9th day, practically moribund, it was given 200 cc. whole juice intravenously and died. The other dog was given whole juice intravenously beginning with the 5th day, rapidly grew worse, but made a spectacular recovery within a few hrs. on receiving whole juice by mouth, and later died when non-dialyzable portion was substituted for whole juice. The essential cause of early death following total drainage of pancreatic juice is not entirely clear. In general, the loss of salts, water and proteins by way of the pancreatic juice and gastric vomitus must play an important role. However, the comparatively slight disturbances in blood chemistry and the improvement in the condition of a moribund dog after oral administration of whole pancreatic juice leave much to be explained.