The present investigation provides follow-up data (up to 36 months) of exocrine and endocrine pancreatic function, inflammatory activity,
pain, and
body weight in 23
chronic pancreatitis patients submitted to Whipple's procedure plus intraoperative
Ethibloc occlusion of the remaining pancreatic duct system between January 1983 and February 1984. Clinically, Whipple's procedure plus intraoperative pancreatic duct occlusion resulted in almost complete and continuous cessation of
pain as well as significant (p less than 0.05) increase in
body weight. With regard to exocrine pancreatic function (
Secretin-
Pancreozymin test, plasma
amino acid consumption test, Pankreolauryl test, fecal
chymotrypsin determination), intraoperative pancreatic duct occlusion was shown to induce high-grade insufficiency and thus exocrine parenchymal
atrophy in all patients. Simultaneously, the inflammatory process (represented by serum levels of
trypsin,
lipase, and pancreatic
isoamylase) was terminated in all 23 patients. Endocrine pancreatic function, evaluated by serum levels of
insulin and
C-peptide measured under fasting conditions and subsequent maximal combined beta-cell stimulation as well as corresponding integrated
hormone releases, was reduced by partial pancreas resection by about 50%, while there was no further impairment during the 36-month follow-up period in consequence of additional intraoperative pancreatic duct occlusion. Altogether, Whipple's procedure plus intraoperative
Ethibloc occlusion of the residual pancreatic duct system seems suitable for termination of the inflammatory process and thus preservation of residual endocrine pancreatic function in
chronic pancreatitis.