Role of the antrum in the regulation of pancreatobiliary secretion
in humans.
Kreiss, Christianna, Werner Schwizer, Urs Erlacher, Jan Borovicka,
Christine L[diaeresis]ochner-Kuery, Renato M[umlaut]uller, Jan B. M.
J. Jansen, Michael Fried.
Departments of Gastroenterology, University Hospitals
Z[umlaut]urich and Lausanne, Switzerland and Nijmegen, The
Netherlands
APStracts 2:0250G, 1995.
Little is known about the role of the gastric phase in the
postprandial pancreatobiliary response. We evaluated the effect of
antral distension on pancreatic, biliary and gastric secretions, and
the release of cholecystokinin, gastrin, and pancreatic polypeptide
in five healthy volunteers. Studies were performed using a duodenal
tube with an inflatable balloon in the antrum and a separate gastric
tube. Outputs were compared with responses to a maximal CCK-stimulus
(caerulein) and the role of cholinergic mechanisms was investigated
using atropine. Graded antral distension by 50, 200, and 350 ml
balloon volumes and constant antral distension by 350 ml elicited a
marked stimulation of pancreatobiliary secretions. Mean lipase
outputs amounted to 52-60% and mean bilirubin outputs reached 14-22%
of maximal. Atropine completely abolished pancreatobiliary responses
to antral distension. Antral distension did not affect bicarbonate
and gastric secretions. Plasma pancreatic polypeptide levels
increased markedly during antral distension and this effect was
completely suppressed by atropine. There were no changes in
circulating gastrin and cholecystokinin. These data demonstrate that
antral distension with already small volumes of 50 ml elicits a
hitherto unknown potent stimulatory effect, indicating a major role
of the antrum in the postprandial pancreatobiliary response in
humans, which is mediated by cholinergic mechanisms.
Received 14 August 1995; accepted in final form 21 November 1995.
APS Manuscript Number G357-5.
Article publication pending Am. J. Physiol. (Gastrointest. Liver
Physiology).
ISSN 1080-4757 Copyright 1995 The American Physiological Society.
Published in APStracts on 8 December 95