The volume of stimulated pancreatic secretion in patients with chronic biliary pancreatitis depending on the functional state of the pancreas and pressure in the proximal duodenum

Objective. To investigate the volume of stimulated pancreatic secretion in patients with chronic biliary pancreatitis depending on the state of excitation and inhibition in the pancreas and pressure in the proximal duodenum after intraduodenal injection of 0.1 M hydrochloric acid and sunflower oil. Materials and methods. We examined 316 patients with chronic biliary pancreatitis. The pancreatic function was assessed by the method of complex fractional gastroduodenal probing, the state of excitation and inhibition in the pancreas – by measuring the pressure in the antral part of the stomach during stimulated pancreatic secretion by the open catheter method. Results. In the group of patients with chronic biliary pancreatitis with a pressure in the antrum of the stomach of 0 – 5 mm Hg, with a pressure in the duodenum after the introduction of sunflower oil of 14 – 18 mm Hg. the proportion of patients with a secretion volume of 0 – 50 ml was higher, and the proportion of patients with a secretion volume of more than 300 ml was lower than at a duodenal pressure of 19 – 42 mm Hg – 16.13 and 1.61% and 7.55 and 15.09%, respectively (p < 0.025). In the group of patients with chronic biliary pancreatitis with unstable pressure in the antral region of the stomach with duodenal pressure after administration of sunflower oil of 14 – 18 mm Hg. The proportion of patients with a secretion volume of 101 – 180 ml was higher, and the proportion of patients with a secretion volume of more than 300 ml was lower than with a duodenal pressure of 19 – 42 mm Hg – 31.58 and 7.89% and 18.42 and 23.68%, respectively (p < 0.05). Conclusions. In chronic biliary pancreatitis with an imbalance of excitation and inhibition in the pancreas, patients with normal excitability of the gland compared to patients with increased excitability of the gland have persistent hyposecretion with a secretion volume of 0–50 ml and no persistent hypersecretion with a secretion volume of more than 300 ml, which can be considered a normal reaction to the inhibitory effect of biliary dyskinesia. In chronic biliary pancreatitis with an imbalance of excitation and inhibition in the pancreas, patients with decreased excitability of the gland have persistent hyposecretion with a secretion volume of 101–180 ml, while patients with increased excitability of the gland have persistent hypersecretion with a secretion volume of more than 300 ml, which can be considered risk factors for the development of chronic and acute pancreatitis.