Pancreatic Function Diagnostant (PFD)對阻塞性黃疸的胰外分泌機能之研究

Abstract

The exocrine pancreatic function diagnostant test is used to evaluate the pancreatic function in patients with obstructive jaundice. The para-aminobenzoic acid (PABA) excretion rate in 6-hour urine samples is 77.83±2.85% (mean ± SE) in 12 healthy volunteers, 52.33±5.87% in 10 patients with gall bladder stone, 40.86±7.36% in 13 patients with common bile duct stone, 54.68±4.96% in 19 patients with intrahepatic stone and 25.16±4.42% in 10 patients with periampullary tumor. The abnormally low excretion of PABA was found in 70%, 69%, 68% and 90% of patients with gall bladder stones, common bile duct stones, intrahepatic duct stones and periampullary tumors respectively. The correlation between serum bilirubin levels (X) and excretion rates of PABA (Y) in 10 cases of gall bladder stone is Y=52.74-0.36X (r=-0.02). The excretion rate of PABA in one case whose serum bilirubin was more than 3 mg/dl was 55.56%. The other 9 cases of gall bladder stone with bilirubin levels of less than 3 mg/dl had an excretion rate of 51.96±6.17% (mean ± SE). In 13 patients with common bile duct stone, the correlation was Y=53.57-1.81X (r=-0.60). Among them, the PABA excretion rate in six cases whose bilirubin were more than 3 mg/dl was 31.43±10.15%. In the other 7 cases whose bilirubin were less than 3 mg/dl, it was 48.93±9.56%. In 19 patients with intrahepatic stones, the correlation was Y=42.08±1.02X (r=0.43). Among them, the PABA excretion rate in 11 cases whose serum bilirubin levels were more than 3mg/dl was 62.47±7.56%. In the other 8 cases whose bilirubin were less than 3 mg/dl it was 43.95±6.33%. The results revealed that the pancreatic exocrine dysfunction may be due to mechanical compression of the distal part of common bile duct, and was not related to the serum bilirubin level.