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Frederic E. Eckhauser, MD; James A. Knol, MD; Mark G. Inman, MS; William E. Strodel, MD

Arch Surg. 1985;120(3):355-360.

Abstract
• Microcirculatory derangements in the pancreas associated with acute pancreatitis may contribute to a low-flow state and lead to pancreatic necrosis. This study investigated the effects of glucagon, a selective mesenteric arterial dilator, on pancreatic ischemia in canine bile-trypsin-induced pancreatitis (BTP). Measurements of cardiac index (CI), total pancreatic blood flow (Q_P), pancreatic oxygen consumption (O₂C_P), and pancreatic arteriovenous shunt flow (Q_AVS) were obtained prior to and after inducing BTP. Bile-trypsin-induced pancreatitis was induced in 18 dogs. Nine received lactated Ringer's solution alone (LRPAN) at 6.5 mL/kg/hr, nine received lactated Ringer's solution plus continuous intravenous (IV) glucagon hydrochloride (GLUPAN) at 1.0 µg/kg/min, and nine undergoing periportal dissection without BTP received IV glucagon (GLUCON). Following BTP, CI, Q_P, and O₂C_P decreased significantly and Q_AVS remained unchanged in crystalloid-treated animals (LRPAN). Glucagon administration (GLUPAN) transiently increased CI and Q_P but failed to improve O₂C_P and did not change Q_AVS. The decrease in O₂C_P observed after BTP in association with a constant Q_AVS suggests a metabolic block to oxygen uptake at the cellular level. Glucagon in pharmacologic doses does not reverse abnormalities in O₂C_P and is therefore of questionable physiologic benefit in the treatment of acute pancreatitis.

(Arch Surg 1985;120:355-360)

Author Affiliations
From the Surgery Service, Veterans Administration Medical Center (Drs Eckhauser, Knol, and Strodel and Mr Inman) and Section of General Surgery, Department of Surgery, University of Michigan Medical Center (Drs Eckhauser, Knol, and Strodel), Ann Arbor.

Footnotes
Accepted for publication Aug 29, 1984.

Read before the Eighth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Los Angeles, May 12, 1984.

Reprint requests to Department of Surgery, Room D-2213-MPB, University of Michigan Hospital, Ann Arbor, MI 48109 (Dr Eckhauser).

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