Abstract
AbstractIn order to find a way to prevent postoperative complications believed to be caused by pancreatic enzymes, we studied the effects on the pancreas of 5‐fluorouracil (5‐FU), daunomycin (DAU), actinomycin D (ACD), vincristine (VCR), and methotrexate (MTX), all of which have an inhibitory effect on protein synthesis. The effects of these drugs were tested on the exocrine cells of Donryu rats and in 12 patients who had had surgical procedures for pancreatic diseases. In control experiments, the uptake of labeled amino acid and autoradiographic studies showed that enzyme synthesis by pancreatic exocrine cells was diminished transiently after surgery but recovered in a short time. All of the drugs produced a decrease of75Se‐selenomethionine uptake in the pancreas.3H‐leucine uptake in the pancreatic protein fraction and autoradiographic studies showed a significant reduction of radioactivity and a decrease of grain counts on zymogen granules in rats treated with 5‐FU and VCR. On the basis of these experimental results, 5‐FU was selected as the most favorable drug. Of 12 patients treated with 5‐FU, one developed a small pancreatic fistula for a short period of time and another had leakage from a pancreaticojejunostomy after pancreaticoduodenectomy. The others had no postoperative complications even when operations were performed in the presence of pancreatitis. 5‐FU produced a decrease in the amount of protein and the activity of amylase in pancreatic juice obtained postoperatively from a catheter in the pancreatic duct of several patients.
Published Version
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