Pancreatic duct ligation in the therapy of chronic pancreatitis

Abstract

Total ligation of the pancreatic ducts of a normal gland in dogs and man results in atrophy of the acinar cells with preservation of islet cell function. Theoretically, this might be applied in the therapy of chronic pancreatitis since, in effect, an exocrine pancreatectomy results. Sustained islet cell function, as evidenced by a normal glucose tolerance test, following pancreatic duct ligation, was demonstrated in dogs for periods of up to two years. Resection of the head of the pancreas and ligation of the distal gland in six patients with chronic pancreatitis and an abnormal glucose tolerance test resulted in the development of insulin-dependent diabetes in all instances. Insulin-dependent diabetes was also demonstrated in one patient with a normal preoperative glucose tolerance test. Recurrent pancreatitis developed in only one patient. The study suggests that pancreatic duct ligation is effective in treating chronic pancreatitis but casts considerable doubt on the effectiveness of this procedure in preventing the development of diabetes, if the glucose tolerance test is abnormal