[Effect of diet and stress on fat and carbohydrate metabolism after duodenopancreatectomy].

In 6 male patients, who had duodenopancreatectomy, oral fat respectively carbohydrate tolerance tests were performed. Intake of at least 10 g pancreatine did reduce the ensuing steatorrhea. Increased oral intake of carbohydrates led to increased levels of glucose in blood and urine. In addition, the patients were subjected to excessive exercise tests; in the course of these tests hormones, substrates and metabolites of fat and carbohydrate metabolism were measured. The values were compared to corresponding values from 6 type I diabetes patients and 7 normal persons. In the operated group lactate and free glycerol increased because of reduced hepatic glucose neogenesis, catecholamines increased little, and HGH not at all. Capacity for work was reduced in the operated group. Malassimilation and diabetes may be compensated for by drug therapy after duodenopancreatectomy. However, endocrine as well as metabolic derangements do follow duodenopancreatectomy, and ought to be taken into account preoperatively, since they may reduce the benefit of surgery in patients with chronic pancreatitis.