Residual pancreatic exocrine function before and after pancreaticoduodenectomy for periampullary cancer

In 25 patients with periampullary cancer receiving pancreaticoduodenectomy (PD), residual function of the exocrine pancreas was assessed by the pancreatic function diagnostant test (PFT) to investigate functional variations during the postoperative course. The volume of excretion of p‐aminobenzoic acid (PABA) in urine for 6 hours before the operation was significantly lower than that in the control group (p<0.01). The 6‐hour excretion level within 2 months after the operation was the same as preoperatively; however, the 6‐hour excretion level 12 months postoperatively was higher than that before the operation (p<0.01) and within 2 months after the operation (p<0.01). An analysis of the urinary excretion pattern of PABA was useful to suggest the status of the pancreatic duct. It may be concluded that the lower level of the PFT before PD resulted from obstruction of the pancreatic duct, that the lower level within 2 months after PD was the result of maldigestion and malabsorption, and that the level of the PFT beyond 12 months after PD was improved to the same level as the control group.