Studies on recovery and variation of pancreatic juice obtained by endoscopic cannulation of the main pancreatic duct in man.

Recovery of pancreatic juice was studied by endoscopic cannulation of the main pancreatic duct, using a double-lumen catheter and infusion of a marker solution (57Co-labeled vitamin B12) into the pancreatic duct. Juice was collected by siphonage. Tracer amounts of 91Cr were infused into the duodenum through a separate catheter attached to the outside of the duodenoscope to determine contamination of duodenal juice. The recovery of the infused marker into the pancreatic duct was poor during the first 15 min of the study, probably because the volume infused merely filled the pancreatic ducts. After this initial period the recovery was slightly less than or exceeded the amount of marker infused per 5-min period. The overall recovery of infused marker was 84% (range 78%--96%). It is concluded that only small amounts of pancreatic juice will leak through the papilla of Vater during endoscopic cannulation under the conditions of this study. The variations in flow rate and concentrations of bicarbonate, amylase, and protein from time to time were studied. Unstimulated and bile-induced flow rate and protein secretion varied considerably within and between subjects. Less marked were the variations of concentrations of bicarbonate and amylase. It is suggested that the large variation may be physiological.