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MeSH Review

Pancreatic Fistula

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Disease relevance of Pancreatic Fistula


High impact information on Pancreatic Fistula

  • METHODS: In conscious rats, plasma PYY was determined in response to oral ingestion of a 6-mL meal and intravenous infusion of PYY; small intestinal transit time was measured by phenol red as a nonabsorbable marker, and pancreatic secretory studies were performed in rats with pancreatic fistulas and jugular vein catheters [6].
  • To characterize this relationship, we measured incremental responses of protein, bicarbonate, and PP to graded doses of intravenous secretin, caerulein, CCK8, CCK33, bethanechol, and intraduodenally perfused HCl, sodium oleate, and L-phenylalanine in dogs with gastric and pancreatic fistulas and compared them with average postprandial values [7].
  • In dogs with gastric and pancreatic fistulas, 168 pmol kg-1 h-1 of CCK produced maximal pancreatic protein output and slightly stimulated gastric acid secretion [8].
  • Each trial reported significant decreases in overall complication rates, and two of the four reported significantly lowered rates of pancreatic fistula in patients receiving prophylactic octreotide [9].
  • Urethane anaesthetised rats with pancreatic fistulas pretreated with 3-0-methyl-glucopyranose (500 mg/kg/h) were stimulated with an intravenous bolus of 2-deoxyglucose (2-DG) (75 mg/kg) [10].

Chemical compound and disease context of Pancreatic Fistula

  • The effect of graded doses of intravenously infused secretin and intestinally perfused sodium oleate and HCl on pancreatic exocrine secretion and plasma secretin was determined in cats and dogs prepared with pancreatic fistulas [11].
  • 1. Pancreatic bicarbonate and protein secretion as well as immuno-reactive plasma secretin concentration in response to a meal, duodenal acidification and exogenous secretin or octapeptide of cholecystokinin (OP-CCK) have been measured following administration of methionine-enkephalin in chronic pancreatic fistula dogs [12].
  • Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate [13].
  • We have studied this problem in fasted dogs with chronic pancreatic fistulas by means of a specific cholecystokinin antagonist, proglumide, to inhibit the effect of cholecystokinin [14].
  • The effects of etorphine, a potent opiate agonist without preferential affinity for mu, delta or kappa receptors, on exocrine pancreatic secretion were studied in rats fitted with chronic or acute pancreatic fistulas and compared to those of methadone, a well-documented mu agonist [15].

Anatomical context of Pancreatic Fistula


Gene context of Pancreatic Fistula

  • Somatostatin and its analogs diminish pancreatic secretion of water and electrolytes and have been effective in treating pancreatic fistulas and pseudocysts [20].
  • The incidence of clinical pancreatic fistula (two of 38 versus eight of 37; P < 0.05) and total pancreatic stump-related complications (five of 38 versus 12 of 37; P < 0.05) was lower in patients treated with S-14 [21].
  • To investigate the possible exocrine pancreatic inhibitory actions of amino acids and fat, pancreatic fistula outputs and plasma concentrations of glucagon, somatostatin, and pancreatic polypeptide were measured for response to intravenous (IV) and intraduodenal nutrient administration in six dogs submaximally stimulated with cholecystokinin [22].
  • We report our experience with eight patients with severe persistent pancreatitis associated with peripancreatic fluid collections requiring placement of drainage catheters who subsequently developed pancreatic fistula [23].
  • Human pancreatic polypeptide (HPP) and its C-terminal hexapeptide (HP-PP) were infused intravenously in graded doses into healthy human subjects and dogs with chronic pancreatic fistula during submaximal stimulation with secretin [24].

Analytical, diagnostic and therapeutic context of Pancreatic Fistula


  1. Effect of 1-phenylpentanol on release of secretin and exocrine pancreatic secretion in dogs and humans. Chey, W.Y., Millikan, L., Lee, K.Y., Watanabe, S., Shiratori, K., Takeuchi, T. Gastroenterology (1983) [Pubmed]
  2. Treatment of pancreatic ascites and external pancreatic fistulas with a long-acting somatostatin analogue (Sandostatin). Segal, I., Parekh, D., Lipschitz, J., Gecelter, G., Myburgh, J.A. Digestion (1993) [Pubmed]
  3. Neuroendocrine tumor of the pancreas in a patient with pernicious anemia. Caggiano, A.V., Adams, D.B., Metcalf, J.S., Anderson, M.C. The American surgeon. (1990) [Pubmed]
  4. Octreotide does not prevent postoperative pancreatic fistula or mortality following Pancreaticoduodenectomy. Barnett, S.P., Hodul, P.J., Creech, S., Pickleman, J., Arahna, G.V. The American surgeon. (2004) [Pubmed]
  5. Recent experience with cancer of the ampulla of Vater in a national hospital group. el-Ghazzawy, A.G., Wade, T.P., Virgo, K.S., Johnson, F.E. The American surgeon. (1995) [Pubmed]
  6. A physiological role of peptide YY on exocrine pancreatic secretion in rats. Jin, H., Cai, L., Lee, K., Chang, T.M., Li, P., Wagner, D., Chey, W.Y. Gastroenterology (1993) [Pubmed]
  7. Pancreatic polypeptide release: role of stimulants of exocrine pancreatic secretion in dogs. Beglinger, C., Taylor, I.L., Grossman, M.I., Solomon, T.E. Gastroenterology (1984) [Pubmed]
  8. Effect of ninety-five percent pure cholecystokinin on gastrin-stimulated acid secretion in man and dog. Corazziari, E., Solomon, T.E., Grossman, M.I. Gastroenterology (1979) [Pubmed]
  9. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Yeo, C.J., Cameron, J.L., Lillemoe, K.D., Sauter, P.K., Coleman, J., Sohn, T.A., Campbell, K.A., Choti, M.A. Ann. Surg. (2000) [Pubmed]
  10. Mechanism of galanin's inhibitory action on pancreatic enzyme secretion: modulation of cholinergic transmission--studies in vivo and in vitro. Herzig, K.H., Brunke, G., Schön, I., Schäffer, M., Fölsch, U.R. Gut (1993) [Pubmed]
  11. The effect of fat on secretin release. Miller, T.A., Konturek, S.J., Llanos, O.L., Rayford, P.L., Thompson, J.C. Ann. Surg. (1978) [Pubmed]
  12. Enkephalin inhibits the release and action of secretin on pancreatic secretion in the dog. Chey, W.Y., Coy, D.H., Konturek, S.J., Schally, A.V., Tasler, J. J. Physiol. (Lond.) (1980) [Pubmed]
  13. Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate. Seewald, S., Brand, B., Groth, S., Omar, S., Mendoza, G., Seitz, U., Yasuda, I., Xikun, H., Nam, V.C., Xu, H., Thonke, F., Soehendra, N. Gastrointest. Endosc. (2004) [Pubmed]
  14. Proglumide inhibits cholecystokinin and meal-stimulated pancreatic secretion and release of pancreatic polypeptide. Beauchamp, R.D., Gomez, G., Nealon, W.H., Townsend, C.M., Greeley, G.H., Thompson, J.C. Surgery (1990) [Pubmed]
  15. Etorphine inhibition of pancreatic exocrine secretion in rats: comparison with methadone. Chariot, J., Appia, F., Vaille, C., Rozé, C. Eur. J. Pharmacol. (1986) [Pubmed]
  16. Effect of somatostatin on exocrine pancreas evaluated on a total external pancreatic fistula of neoplastic origin. Roncoroni, L., Violi, V., Montanari, M., Muri, M. Am. J. Gastroenterol. (1983) [Pubmed]
  17. The importance of gastric secretion in the feedback control of interdigestive and postprandial pancreatic secretion in rats. Konturek, S.J., Krzyzek, E., Bilski, J. Regul. Pept. (1991) [Pubmed]
  18. Contemporary treatment strategies for external pancreatic fistulas. Howard, T.J., Stonerock, C.E., Sarkar, J., Lehman, G.A., Sherman, S., Wiebke, E.A., Madura, J.A., Broadie, T.A. Surgery (1998) [Pubmed]
  19. The endogenous secretin in chicken: minor physiological role in exocrine pancreatic secretion. Kokue, E., Hayama, T. Jpn. J. Physiol. (1976) [Pubmed]
  20. Receptor strategies in pancreatitis. Grendell, J.H. The Yale journal of biology and medicine. (1992) [Pubmed]
  21. Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy. Gouillat, C., Chipponi, J., Baulieux, J., Partensky, C., Saric, J., Gayet, B. The British journal of surgery. (2001) [Pubmed]
  22. Inhibition of the stimulated canine exocrine pancreas by amino acids and fat. Stubbs, R.S., Stabile, B.E. Archives of surgery (Chicago, Ill. : 1960) (1989) [Pubmed]
  23. Pancreaticoenteric fistula: no longer a surgical disease? Wolfsen, H.C., Kozarek, R.A., Ball, T.J., Patterson, D.J., Traverso, L.W., Freeny, P.C. J. Clin. Gastroenterol. (1992) [Pubmed]
  24. Effect of human pancreatic polypeptide and its C-terminal hexapeptide on pancreatic secretion in man and in the dog. Konturek, S.J., Meyers, C.A., Kwiecień, N., Obtułowicz, W., Tasler, J., Oleksy, J., Kopp, B., Coy, D.H., Schally, A.V. Scand. J. Gastroenterol. (1982) [Pubmed]
  25. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease. Lowy, A.M., Lee, J.E., Pisters, P.W., Davidson, B.S., Fenoglio, C.J., Stanford, P., Jinnah, R., Evans, D.B. Ann. Surg. (1997) [Pubmed]
  26. Experimental evidence for a vagally mediated and cholecystokinin-independent enteropancreatic reflex. Fried, G.M., Ogden, W.D., Sakamoto, T., Greeley, G.H., Thompson, J.C. Ann. Surg. (1985) [Pubmed]
  27. Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos). Seewald, S., Groth, S., Omar, S., Imazu, H., Seitz, U., de Weerth, A., Soetikno, R., Zhong, Y., Sriram, P.V., Ponnudurai, R., Sikka, S., Thonke, F., Soehendra, N. Gastrointest. Endosc. (2005) [Pubmed]
  28. Role of endogenous nitric oxide in the control of exocrine and endocrine pancreatic secretion. Bilski, J., Konturek, S.J., Bielański, W. J. Physiol. Pharmacol. (1995) [Pubmed]
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