Gastroenterology

Gastroenterology

Volume 75, Issue 6, December 1978, Pages 1083-1089
Gastroenterology

Profiles of pure pancreatic secretions obtained by direct pancreatic duct cannulation in normal healthy human subjects

https://doi.org/10.1016/0016-5085(78)90080-XGet rights and content

Abstract

The development of endoscopic retrograde cannulation of the pancreatic duct allows collection of pure pancreatic juice uncontaminated by bile and duodenal secretions. We have analyzed such pure pancreatic juice to establish secretory profiles of some normal components. Fifteen healthy human volunteers were studied. Secretin (1 clinical unit per kg) was injected intravenously at time 0, and 16 min later cholecystokinin-pancreozymin (CCK-PZ) (1 Ivy dog unit per kg) was injected intravenously. Pure pancreatic juice was collected for 32 min in timed minute samples. Secretin produced an almost immediate and sustained flow of juice (3.15 ± 0.24 ml per min) with initial high concentrations of protein and enzyme. After CCK-PZ, flow increased significantly to 3.40 ± 0.29 ml per min (P < 0.02) and enzyme concentration rose some 10-fold above that found during secretin stimulation. The maximum of the CCK-PZ effect occurred 2 to 3 min after injection and its half-life was 73 to 90 sec for total protein and enzymes but only 64 sec for trypsin inhibitor. Repeat studies in 3 subjects indicate marked reproducibility for these various parameters. Trypsinogen and proelastase appeared to be secreted in a parallel fashion but nonparallel secretion for amylase, chymotrypsin, and trypsin inhibitor was observed. Amylase secretion was proportionately less and trypsin inhibitor secretion proportionately more stimulated by CCK-PZ than was chymotrypsinogen. Collections of single minute samples of pure pancreatic juice reveal a more accurate profile of secretory events than does collection of pooled samples for 10 to 20 min as hitherto performed by other workers.

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This study was supported by a grant from the Medical Research Service of the Veterans Administration and the National Cancer Institute, Grant R26 CA 20222-01 through the National Pancreatic Cancer Project, and a grant from the LAC-USC Comprehensive Cancer Center.

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