Laboratory diagnostic tests for pancreatic diseases were carried out by examination of samples of parotid saliva in 22 patients, of whom 9 were with pancreatic disorders and 13 with disorders of other organs or systems. Trend analyses of the data thereby obtained revealed the approximate borderline values (lower for pancreatic diseases and higher for non-pancreatic disorders) for the rate of salivary secretion, its maximum bicarbonate concentration and amylase secretion to be 0.6ml per minute, 20mEq/L, and 1,000 units per kg of body weight, respectively.The results of the present study emphasize potential usefulness of the examination of parotid saliva as a reliable diagnostic means for diseases of the pancreas.pancreas; pancreatitis; parotid gland; amylase; bicarbonate In a previous study of ours evidence had been already obtained for degenera tion of the parotid gland associated with some dysfunction of the parotid, viz. decreased parotid salivary secretion, decline in the maximal bicarbonate concent ration and diminution of amylase secretion, in the presence of pancreatitis or other forms of disorders of the pancreas (Kakizaki et al. 1971; 1972 a, b, c).The present communication deals with the clinical application of these experi mental findings. MATERIAL AND METHODSSubjects: As shown in Table 1, were studied a series of 22 cases, including 9 with pancreatic diseases and 13 with non-pancreatic disorders, and the diagnoses were confirmed upon laparotomy. Collection of saliva samples:With the patient in the lateral position, a saliva-sampling apparatus was attached closely onto the orifice of the parotid on one side and 1% pilocar pine hydrochloride was injected intramuscularly in a dose of 0.13mg per kg. After the parotid saliva began secreting thereby, samples of saliva were collected continuously on 5 consecutive samples for 5minutes each, for 25minutes in total, into a graduated test tube.At the end of the saliva sampling the patient was given an intramuscular dose of 0.13mg atropine sulfate per 10kg of body weight.

In a study of 66 patients with pancreaticoduodenal cancer with pancreaticoduodenectomy, there were five (7.5%) hospital deaths. Five-year survival rates were 7.8% in 20 patients with carcinoma of the head of the pancreas, 16.7% in 31 patients with carcinoma of the bile duct, and 38.5% in 15 patients with carcinoma of the ampulla of Vater. Fecal fat loss measured was 10 g or less per day in nine of 12 patients. Of the 19 patients having glucose tolerance tests, 13 showed abnormalities including the two who were diabetic. Operative findings which were indicative of a poor prognosis included lymph node metastases, macroscopic invasion of the tumor into the pancreatic capsule in patients with carcinoma of the head of the pancreas, the size of the tumor in those with carcinoma of the common bile duct, and direct invasion of the lesion into the pancreas in patients with carcinoma of the ampulla of Vater.

No abstract

No abstract

No abstract