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The Effect of Pancreatic Fistula on Gastric Secretion

The Effect of Pancreatic Fistula on Gastric Secretion Abstract Zollinger and Ellison first called attention to instances of recurrent peptic ulceration associated with islet cell tumors of the pancreas.1 These were characterized by hyperacidity and hypersecretion of acid gastric juice and not controlled by vagotomy and extensive gastric resection. Previous experimental studies have also demonstrated an interrelationship between the pancreas and gastric secretion. Dragstedt reported in 1942 that approximately 100% of dogs with external total pancreatic fistulae developed duodenal ulcer, whereas dogs in whom the pancreatic ducts had been ligated had only a 29% incidence of duodenal ulcer. He further found that dogs upon whom a pancreatectomy had been performed developed ulcer in only 1%-3%.2 In all three of these preparations the external secretion of the pancreas is absent from the duodenum. The internal drainage of bile and pancreatic juice to the terminal ileum in the Mann-Williamson dog also results in a high incidence of peptic ulceration. References 1. Zollinger, R. M., and Ellison, E. H.: Primary Peptic Ulcerations of the Jejunum Associated with Islet Cell Tumors of the Pancreas , Ann. Surg. 142:709-728 ( (Oct.) ) 1955.Crossref 2. Dragstedt, L. R.: Pathogenesis of Gastroduodenal Ulcer , Arch. Surg. 44:438-451 ( (March) ) 1942.Crossref 3. Storer, E. R.; Oberhelman, H. A., Jr.; Woodward, E. R.; Smith, C. A., and Dragstedt, L. R.: Effect of the Exalto-Mann-Williamson Procedure on Gastric Secretion , A.M.A. Arch. Surg. 64:192-199 ( (Feb.) ) 1952.Crossref 4. Greenlee, H. B.; Longhi, E. H.; Delgadillo, J.; Nelsen, T. S.; El-Bedri, A. L., and Dragstedt, L. R.: Inhibitory Effect of Pancreatic Secretin on Gastric Secretion , Am. J. Physiol. 190:396-402 ( (Sept.) ) 1957. 5. Barcena, J.; Bravo, J. L.; Baugh, C. M.; Mountain, C. F., and Dragstedt, L. R.: Effects of Total Pancreatectomy on Gastric Secretion , S. Forum 7:380-382, 1957. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

The Effect of Pancreatic Fistula on Gastric Secretion

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1959.04320120146018
Publisher site
See Article on Publisher Site

Abstract

Abstract Zollinger and Ellison first called attention to instances of recurrent peptic ulceration associated with islet cell tumors of the pancreas.1 These were characterized by hyperacidity and hypersecretion of acid gastric juice and not controlled by vagotomy and extensive gastric resection. Previous experimental studies have also demonstrated an interrelationship between the pancreas and gastric secretion. Dragstedt reported in 1942 that approximately 100% of dogs with external total pancreatic fistulae developed duodenal ulcer, whereas dogs in whom the pancreatic ducts had been ligated had only a 29% incidence of duodenal ulcer. He further found that dogs upon whom a pancreatectomy had been performed developed ulcer in only 1%-3%.2 In all three of these preparations the external secretion of the pancreas is absent from the duodenum. The internal drainage of bile and pancreatic juice to the terminal ileum in the Mann-Williamson dog also results in a high incidence of peptic ulceration. References 1. Zollinger, R. M., and Ellison, E. H.: Primary Peptic Ulcerations of the Jejunum Associated with Islet Cell Tumors of the Pancreas , Ann. Surg. 142:709-728 ( (Oct.) ) 1955.Crossref 2. Dragstedt, L. R.: Pathogenesis of Gastroduodenal Ulcer , Arch. Surg. 44:438-451 ( (March) ) 1942.Crossref 3. Storer, E. R.; Oberhelman, H. A., Jr.; Woodward, E. R.; Smith, C. A., and Dragstedt, L. R.: Effect of the Exalto-Mann-Williamson Procedure on Gastric Secretion , A.M.A. Arch. Surg. 64:192-199 ( (Feb.) ) 1952.Crossref 4. Greenlee, H. B.; Longhi, E. H.; Delgadillo, J.; Nelsen, T. S.; El-Bedri, A. L., and Dragstedt, L. R.: Inhibitory Effect of Pancreatic Secretin on Gastric Secretion , Am. J. Physiol. 190:396-402 ( (Sept.) ) 1957. 5. Barcena, J.; Bravo, J. L.; Baugh, C. M.; Mountain, C. F., and Dragstedt, L. R.: Effects of Total Pancreatectomy on Gastric Secretion , S. Forum 7:380-382, 1957.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Dec 1, 1959

References