Thoracic Duct Lymph Amylase in Patients With Chronic Pancreatic Disease After Administration of Secretin

Lymphatic Vessel Network Structure and Physiology

“…For lymphatics draining exocrine organs, the concentrations of the secreted enzymes in lymph may exceed that of the plasma (809, 1037). For example, pancreatic enzymes and bicarbonate, although primarily secreted into the pancreatic duct, also enter the interstitial space and are absorbed into pancreatic lymph (70, 841). Concentrations of secreted enzymes in lymph will also become elevated if there are obstructions of secretory ducts that divert enzymes in the secretions to the plasma and lymph, such as with obstruction of the pancreatic ducts (841).…”

“…The hormone secretin, which is known to elicit release of pancreatic enzymes, has been suggested in some reports to elevate thoracic duct lymph flow and increase pancreatic enzyme concentrations in thoracic duct lymph due to increased pancreatic lymph output (59, 69, 286). However, other reports dispute this and note that the daily lymph output from the pancreas is relatively small (70, 839, 841). Considering the complexity of the duodenal cluster unit, lymph flow elevations from the pancreas during enzyme secretion to the gut are likely accompanied by elevations in blood flow to the other gastrointestinal organs, plus increased absorption of water and fats from the gut that would also contribute to the elevated lymph flow in the thoracic duct.…”