[The blood drainage of Langerhans islets with special reference to the functional and clinical significance of pancreatic exocrine part].

OBJECTIVE

This study sought to gain an insight into the blood drainage of Langerhans islets with special reference to the functional and clinical significance of pancreatic exocrine part.

METHODS

Observations were carried out in 11 human dead bodies, 40 monkeys, 24 dogs, 62 rats and 24 rabbits by scanning electron microscopy and light microscopy with the technique of retaining microcirculatory dynamic and tissular information in the static specimens, microvascular serial reconstruction, and/or by intravital fluorecence microscopy with FITC-labeled erythrocytes.

RESULTS

Three patterns of islet drainage channels drained into different acinar regions with different features and insulo-insular drainage channels observed in the primates were found in this study. The authors suggest that these patterns might be termed as follows: 1. Continuous drainage vessels. All islets possessed these capillary-sized portal vessels which ran a short distance, and then drained into the peri-islet acinar region. 2. Convergent drainage vessels. Some islets possessed one or two, occasionally more, of these portal vessels, which were relatively long and/or thick and drained into the acinar region far away from the islet in the lobule. 3. Translobular drainage vessels. These portal vessels crossed the interlobular septum into an adjacent lobule where sometimes no islet existed, and then drained into the exocrine acinar region 4. Insulo-insular drainage vessels. Some islets in the monkey and human, possessed these vessels which drained into an adjacent small islet through the insulo-insular drainage vessels.

CONCLUSION

Langerhans islets possessed the consummate drainage system which drained into different exocrine acinar regions, suggesting that the release of islet hormones is in some way necessary for the exocrine secreting function, and that the reduction of local insular hormone levels in insuloacinar portal circulation and the impairment of insular drainage vessels would be the morphological basis of the pancreatic exocrine pathologic lesion in human diabetes.