Liver Changes After Deprivation of External Pancreatic Secretion

Abstract

In a recent investigation concerning the physiology of pancreatic secretion a series of dogs was deprived completely of pancreatic juice by means of fistulas made according to the Elman and McCaughan modification of the Rous-McMaster technique and by ligation of the pancreatic ducts. At autopsy, histological examination of the livers of these animals revealed striking changes. In fistula dogs which succumbed 7 to 10 days after the loss of pancreatic juice, early degenerative changes such as cloudy swelling and moderate fatty infiltration of the liver cells were observed. In fistula dogs which survived for longer periods (17, 20, 20, 20, 24, 25, 25, 32, 51 and 56 days respectively) the histological alterations were more pronounced and consisted of one or more of the following : fatty infiltration and necrosis of the liver cells, congestion of the capillaries around the central veins, atrophy of the liver cords, dilatation of the bile canaliculi and biliary cirrhosis. Some of the animals in this group received daily intravenous injections of NaCl and NaHCO3; others continued for 3 weeks or longer without any form of treatment. Extensive fatty infiltration of the liver also occurred after prolonged obstruction of the pancreatic ducts (80 days). After varying periods of exclusion of pancreatic secretion from the intestine, the dogs lost their appetites, declined rapidly in weight, showed marked weakness and apathy, became jaundiced in a few instances, developed a bloody diarrhea and finally succumbed. Vomiting did not occur except in isolated instances. Allan, Bowie, MacLeod and Robinson observed similar symptoms and pathologic changes, in depancreatized dogs treated with insulin. They found an actual increase in the total lipids of the liver and suggested that the pancreas produced an internal secretion, possibly a lipase, which was required by the liver for the mobilization of fat.