Experimental study for pathogenesis of chronic alcoholic pancreatitis

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Pathogenesis of chronic alcoholic pancreatitis (CAP) has been unclear. However, pancreatic duct obstruction and ischemia play an important role in CAP.We prepared the following four groups.Group A (n=9) : after preparing a gastric fistula, 2.0 g kg^<-1> day^<-1> of ethanol was administered via a gastric cannula. Group O (n=7) : after ligation of the minor pancreatic duct, the duodenum was incised to insert a polyethylene tube into the major duct. Group AO (n=9) : both manipulations used in group A and O were applied to this group. Group C (n=9) : laparotomy only. Laparotomy was reperformed 3 months later in each group.In group O,mild periductal fibrosis was recognizad without parenchymal cell damage. In group AO,fibrosis extended further into the peri-ductal and inter-lobular regions, and parenchymal cell damage with chronic inflammatory cell infiltration was seen. The secretin test revealed a significantly decreased flow rate, bicarbonate concentration and amylase output in group AO when conpared to the control gloup. In group O,flow rate and amylase output were significantly reduced in comparison to that in control. In group AO,pancreatic blood flow was decreased significantly in comparison to that in control.We concluded that pancreatic duct obstruction increased the parenchymal cell damage induced by alcohol administration, and that decrease of blood flow has an aggravating effect on the chronic alcoholic pancreatitis lesion. This model was very representative of human CAP.