Effect of Ligation of the Pancreatico-Duodenal Artery on the Blood Sugar and Urine.

In previous papers 1 , 2 the author and co-workers presented experimental evidence which seemed to indicate that changes in the permeability of the capillary vessels of the pancreas, produced by perfusions of its arterial supply, resulted in a mobilization of trypsin into the blood stream, via the portal circulation, with the production of a hyperglycemia and glycosuria. It was also suggested that the presence of trypsin in the blood stream may be part of the mechanism regulating the secretion and activity of insulin under normal and pathological conditions.

In part our work has received confirmation by the histological findings of Horning, 3 Collens, 4 however, reaches certain conclusions which are not in accord with our own. This investigator employed a technic totally different from ours, and failed to ascertain what differences in results his procedures would cause.

The purpose of this communication is to record additional data which throws considerable light on the subject.

We perfused the pancreatico-duodenal artery without the application of ligatures to adjacent vessels, whereas Collens perfused the hepatic artery after ligating the pancreatico-duodenal. Then he perfused the pancreatico-duodenal artery after ligating the hepatic. No mention is made of control experiments on the effect of ligation of these respective vessels without the perfusion of any others.

The result of ligation of the hepatic arteries upon carbohydrate metabolism is known to be comparable in its effect to complete ablation of the liver. 5 , 6 It has been termed “Blotodless hepatectomy,” and is accompanied by a rapid disappearance of glycogen from the liver and a hypoglycemia. In view of the profound effects upon the carbohydrate metabolism produced by the ligation of the hepatic arteries, such a procedure cannot be employed with safety for the purpose of studying the effects of perfusion of the pancreas.