In a previous study we have shown that acute experimental pancreatitis is associated with an increase in the volume and enzyme concentration of lymph collected from thoracic duct fistulas.1 Following the initial high flow rate, there was a precipitous reduction of lymph volume which coincided with appearance of hematochylia. Duprez, in a discussion we had with him in 1965, stated that he infused this sanguineous lymph into the pancreatic ducts of normal dogs and found that recipient animals developed severe pancreatitis.
When no replacement therapy was given, dogs with thoracic duct fistulas all died early in the course of acute pancreatitis, while some of the animals given parenteral colloid survived. Thus, thoracic duct drainage appeared to offer a method for removal of potentially toxic fluid from the inflamed pancreas and prevent its entry into the general circulation.
Severe pancreatitis causes an acute depletion of circulating blood and plasma volume.
Schiller WR, Duprez A, Iams WB, Suwa M, Anderson MC. Experimental Pancreatitis: Treatment by Colloid Replacement and Adrenocorticosteroid Therapy Combined With Thoracic Duct Drainage. Arch Surg. 1969;98(6):698–702. doi:10.1001/archsurg.1969.01340120046004
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