Clinical Evaluation of Fat Digestion and Absorption by Means of Stable Isotopes After Pancreatoduodenectomy

Akio Sakamoto, Sadahito Usui, Soichiro Toyoizumi, Satoru Takaishi, Yoshihiro Nabeya, Kazuaki Okuyama, Shoichi Onoda, Kaichi Isono, Munemasa Ryu*

2nd Department of Surgery, Chiba University School of Medicine
*Department of Surgery, Chiba Cancer Center

This study was performed to investigate fat digestion and absoption after pancreatoduodenectomy by using ¹⁴C-labeled stable isotopes. Fourteen gastrectomized patients and 28 patients who had undergone pancreatoduodenectomy were given either ¹³C-octanoic acid or ¹³C-trioctanoin with 15 g of medium chain triglyceride. Expired breath samples were collected during 3 hours and ¹³C abundance was determined by massspectromety. The results were as follows. 1) A significant decrease in percent recovery of ¹³C-trioctanoin was observed in patients who received pancreatoduodenectomy. 2) Percent recovery of ¹³C-octanoic acid was slightly decreased in pancreatoduodenectomized patients, but the decrease was not statistically significant. 3) There was a significant correlation between ¹³C-trioctanoin breath tests and fecal chymotrypsin activity. 4) There was a significant correlation between ¹³C-octanoic acid breath tests and 25-g D-xylose absorption rates. These results suggest that there is a great reduction in pancreatic exocrine function after pancreatoduodenectomy.

Key words
fat digestion and absorption after pancreatoduodenectomy, ¹³C-octanoic acid breath test, ¹³C-trioctanoin breath test

Reprint requests
Akio Sakamoto 2nd Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chiba, 280 JAPAN

Accepted
October 11, 1989

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