Simultaneous Measurements of Total Pancreatic, Biliary, and Gastric Outputs in Man Using a Perfusion Technique

Abstract

A method, featuring perfusion of both gastric and duodenal markers with collections from the stomach and duodenum, was developed and validated for simultaneous measurements of total duodenal and gastric secretory outputs in man. Calculations of duodenal reflux into the stomach, of contamination of duodenal contents by gastric contents, and of the amounts -recycled between the two organs were made. The values so obtained were used to establish application of duodenal perfusion (with simultaneous gastric aspiration) for precise measurements of total secretions into the duodenum by simple calculations. The technique was used to show that total pancreatic enzyme output after intraduodenal stimulation by perfused amino acids was identical with that obtained after a maximally tolerated dose of pancreozymin given by vein. However, simultaneous intraduodenal and intravenous stimulation caused a pancreatic enzyme output significantly exceeding either method of stimulation alone, or any previously reported, thereby suggesting that conventional stimuli cannot attain maximal secretory capacity for enzymes. When applied to determination of total bilirubin output in the duodenum, the results approximated those reported by other methods.