COMPARATIVE STUDIES ON EXOCRINE PANCREATIC FUNCTION AND GASTRIC SECRETORY FUNCTION IN PATIENTS WITH PEPTIC ULCER BY MEANS OF ANALYSIS OF ENDOSCOPICALLY OBTAINED PURE PANCREATIC JUICE -PART 1-

Abstract

Comparative studies on gastric secretory function and exocrine pancreatic function were made in nine healthy controls, six patients with gastric ulcer and 10 patients with duodenal ulcer by means of biochemical analysis of gastric juice and endoscopically obtained pure pancreatic juice (PPJ). Gastric juice was obtained through a Rehfuss tube at 10 minutes intervals for 60 minutes before AOC-tetra-peptide stimulation and for 60 minutes following the stimulation (4ug/kg). PPJ was obtained by endoscopic retrograde catheterization of the papilla at one minute intervals for 20 minutes after a rapid intravenous injection of secretin (Eisai, 1 U/kg) and for 10 minutes after CCK-PZ injection (Boots, 1 U/kg). Following results were obtained : patients with duodenal ulcer showed significantly raised basal acid concentration (BAC), basal acid output (BAO) and maximal acid output (MAO); patients with duodenal ulcer showed significantly raised bicarbonate concentration in the initial fraction of PPJ and raised bicarbonate output during secretin phase; a significant correlation was noted between bicarbonate concentration in the initial fraction of PPJ and BAC, BAO and MAO; a significant correlation was also noted between bicarbonate output and BAC, BAO and MAO. These results suggest that the bicarbonate secretion of the pancreas is proportionally raised in patients with duodenal ulcer to neutralize the raised gastric acid secretion. These findings were discussed in relation to the pathogenesis of duodenal ulcer.