Abstracts
1999 Digestive Disease Week

# 2138 PROTEIN-DIGESTIVE AND -ABSORBING FANCTIONS AFTER PYLORUS-PRESERVING PANCREATODUODENECTOMY
Ohshima Satoshi, Nakamori Shoji, Sakon Masato, Aoki Taro, Shiozaki Ken, Okami Jiro, Nagano Hiroaki, Dono Keizo, Umeshita Koji, Monden Morito, Osaka Univ Med Sch, Suita Japan

Pylorus-preserving pancreatoduodenectomy (PPPD) has been widely accepted as one of the standard surgical procedures for pancreatic and periampullary disease. A verity of physiological properties of the patients who underwent PPPD has been reported to be better than those who underwent pancreatoduodenectomy with distal partial gastorectomy (standard PD). Therefore, PPPD seems to have the advantage of good nutritional recovery after operation. However, it still remain obscure whether or not PPPD has favorable protein-digestive and absorbing function rather than standard PD. To evaluate these functions after PPPD, we measured the branched chain amino acid (BCAA) concentrations in plasma after ingestion of the standard meal in patients who underwent PPPD or standard PD and normal health volunteers. Eighteen patients who underwent PPPD or standard PD for pancreatic and periampullary disease were enrolled in this study after informed consent. Nine patients (7 malignant diseases and 2 benign diseases) underwent PPPD and nine (8 malignant diseases and 1 benign disease) underwent standard PD. All patients were received regular follow up more than one year after the surgery and had no evidence of either the recurrent disease or other diseases. After 12 hours fasting, patient ingested a test meal (1 hamburger, 1 boiled egg, and 200 ml of milk containing approximately 15g of protein). Blood samples were obtained before the ingestion and 1, 2 and, 4 hours after the ingestion. Branched chain amino acid (BCAA) concentrations in plasma were determined. BCAA concentrations in plasma were also measured with the same schedule in 20 healthy volunteers. The BCAA concentrations reached their maximum at 2 hours after ingestion in healthy volunteers and PPPD patients, while they did not increase in the patients who underwent standard PD. The BCAA concentrations at 1 and 2 hours after ingestion were significantly higher in healthy volunteers and PPPD patients than those in standard PD patients (p<0.05). These findings suggest that function of protein-digestion and -absorption in the PPPD patients should be maintained after surgery.

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