Fat Assimilation after Massive Distal Pancreatectomy

Abstract

Fat assimilation was determined by 219 daily balance studies in seven patients who had had massive distal pancreatectomy for pancreatitis with preservation of the integrity of the gut lumen. Intraluminal contents were analyzed for pH, lipase concentration and hydrolytic products of neutral fat. In six patients with a 95 per cent pancreatectomy, the mean coefficient of fat absorption was 80 per cent, and fat absorption was significantly improved to the same degree whether pancreatic replacement therapy was given with meals or every hour during waking hours. Lipase concentrations of jejunal aspirates were 10 per cent of those in controls. Triglyceride hydrolysis in the pancreatectomized patients was normal, but there was impaired lipolysis of diglycerides. Five of these six patients had impairment of glucose metabolism requiring 22 to 50 units of insulin daily. In one patient with a 75 per cent pancreatectomy fat assimilation was normal.