Effect of intravenous infusion of amino acids on pancreatic secretion.
OBJECTIVE
The effect of intravenous administration of amino acids on exocrine pancreatic secretion is controversial. Since amino acids are used in parenteral nutrition of patients with acute pancreatitis or other pancreatic diseases, it seemed useful to establish whether or not they affect pancreatic secretion.


METHODS
Four patients having an external transduodenal drainage of the main pancreatic duct performed after sphincteroplasty for common bile duct stones were studied. Two of them had undergone a Billroth II gastrectomy in the past. Pancreatic secretion was stimulated with low doses of secretin (0.1 CU/kg/h) and cerulein (10 ng/kg/h); after 75 min of stimulation, when pancreatic secretion was stable, a solution of L-amino acids (Freamine III 8.5%) was infused intravenously at a rate of 150 mL/h, for two hours. The volume of pancreatic secretion, bicarbonate and total protein was measured.


RESULTS
The infusion of amino acids did not cause significant changes in pancreatic secretion. However, considering the results individually, they caused a clear increase of pancreatic secretion, mainly of bicarbonates (mean increase of 36%) in the two subjects who had not undergone previous surgical procedures and no increase in the two who had had a Billroth II gastrectomy.


CONCLUSIONS
The results suggest that intravenous administration of amino acids stimulates exocrine pancreatic secretion in normal subjects but not in those who underwent previous gastrectomy. This stimulatory effect could be mediated by stimulation of gastric acid. This effect should be taken into consideration when amino acids are used in patients with acute pancreatitis or other pancreatic disorders.
Gullo
Lucio
L
Department of Internal Medicine and Gastroenterology, University of Bologna, Sant' Orsola Hospital, Via Massarenti 9, 40138 Bologna, Italy.
Migliori
Marina
M
Campana
Davide
D
Tomassetti
Paola
P
Pezzilli
Raffaele
R
D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage / Q000494:pharmacology*; D001639:Bicarbonates / Q000378:metabolism; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism*
D000596:Amino Acids; D001639:Bicarbonates