The Fatal Effect of the Complete Loss of Pancreatic Juice.

Abstract

In order to collect the total external secretion of the pancreas, a new method seemed necessary. The older procedures,^{1, 2} by which an open fistula was made, permitted the licking of the juice by the animal, and always led to infection of the secretion followed by inflammatory changes in the gland. Such a method was devised in 1923 by Rous and McMaster³ and was used by them for the collection of the total bile under sterile conditions. We have employed the same technique for the collection of the total pancreatic juice. In brief, a cannula was placed in the large duct of the pancreas in dogs, connected with long rubber tubes leading to the outside and joined to a closed rubber balloon provided with an opening for the periodic collection of the accumulated secretion. The smaller duct or ducts were ligated and cut and omentum interposed between the head of the pancreas and the duodenum to insure against reconstitution.

When mechanical obstruction or accidental infection did not occur the pancreatic juice flowed uninterruptedly and on the fifth to eighth day, quite to our surprise, the animals died with evidences of marked asthenia. The course was similar in all 12 instances studied. For a day or two after operation they appeared normal and ate well. The appetite soon diminished and by the fourth day only water was taken. Vomiting was first noted on the third or fourth day and became gradually worse. They drank large quantities of water which was promptly returned. Asthenia was noted early and increased steadily. The temperature, pulse rate, and respirations remained normal.