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February 1973

Reply to Silen's Letter: "Pancreatectomy and Liver Damage" (January 1973)

Author Affiliations

Des Moines, Iowa

Arch Surg. 1973;106(2):239. doi:10.1001/archsurg.1973.01350140095029

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To the Editor.—We appreciate Dr. Silen's interest in our paper (Archives 105:454-456, 1972) and hope the following comments will be helpful in answering his letter.

The replacement therapy selected by us to prevent or reverse fatty changes in the liver following pancreatectomy in the dog consisted of pancreatin and methionine. The pancreatic exocrine replacement was administered in the form of entericcoated pancreatin capsules mixed in with the food. We feel the entericcoated capsules had largely left the stomach by the time the gastric pH became acid enough to destroy enzyme activity. The methyl donor, methionine, was also administered in enteric capsules. We intentionally selected a minimal dosage schedule replacement therapy. The fact that our group 3 dogs never developed fatty infiltration and that our group a2a dogs recovered from their fatty infiltration attests to the adequacy of the replacement therapy in these dogs.

We can't answer specifically whether our

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