Clinical studies on duct occlusion with prolamine.

To prevent recurrence the pancreatic duct occlusion firstly was employed in the treatment of chronic pancreatitis. In combination with a Whipple's procedure a duct occlusion of the situ remaining pancreatic tail was performed in 141 cases since 1978. In the late follow-up only one patient developed a recurrent pancreatitis. In patients with pre-operatively normal glucose tolerance no post-operative diabetes was induced by this method. On the basis of these findings ductal occlusion also was carried out in a case of simultaneous pancreas-kidney-transplantation. Whereas the kidney did not function satisfactorily, the grafted pancreas with obstructed duct showed good endocrine function for over 9 weeks. The patient, who previously required injections of 60 IU insulin daily, needed no insulin during this period. The serum insulin level in several determinations was markedly above that of healthy normal people (65,3 microU/ml). Because of an infection which was uncontrollable under immunosuppression, the pancreas had to be removed again.