Tamura K, Sutherland D E, Kaneko G
Department of Surgery, University of Minnesota, Minneapolis.
Pancreas. 1988;3(3):324-31. doi: 10.1097/00006676-198805000-00014.
We investigated the effect of denervation after heterotopic segmental pancreas autotransplantation on the exocrine function of the graft. The weight of the pancreas segment was determined, and secretory volume, bicarbonate output, and amylase activity were measured before and after i.v. infusion of secretin and cholecystokinin (CCK)-8. The studies were performed in untreated normal dogs, at 2 months postoperatively in partially pancreatectomized dogs with an innervated segment left in situ, and in totally pancreatectomized recipients of denervated heterotopic autotransplanted segments (approximately 30% of whole pancreas). The weight of the pancreas segment was similar in innervated and denervated dogs. Basal pancreatic secretory volume, bicarbonate output, and amylase activity were largely independent of cholinergic control. The secretory volume and bicarbonate output response to i.v. gut hormones (mainly secretin) were slightly modulated by cholinergic activity, whereas amylase response to gut hormones (mainly CCK-8) was quite independent of cholinergic control. We conclude that, after pancreas transplants, the effect of denervation on graft exocrine function is negligible--a finding that is reassuring if preserving of the exocrine tissue is important for optimal endocrine function of the graft.
我们研究了异位节段性胰腺自体移植后去神经支配对移植物外分泌功能的影响。测定胰腺节段的重量,并在静脉注射促胰液素和胆囊收缩素(CCK)-8前后测量分泌量、碳酸氢盐输出量和淀粉酶活性。研究在未经处理的正常犬、术后2个月的部分胰腺切除且保留原位神经支配节段的犬以及去神经支配的异位自体移植节段(约占全胰腺的30%)的全胰腺切除受者中进行。神经支配和去神经支配犬的胰腺节段重量相似。基础胰腺分泌量、碳酸氢盐输出量和淀粉酶活性在很大程度上不依赖于胆碱能控制。静脉注射肠道激素(主要是促胰液素)后的分泌量和碳酸氢盐输出反应受到胆碱能活性的轻微调节,而淀粉酶对肠道激素(主要是CCK-8)的反应则完全不依赖于胆碱能控制。我们得出结论,胰腺移植后,去神经支配对移植物外分泌功能的影响可以忽略不计——如果保留外分泌组织对移植物的最佳内分泌功能很重要,那么这一发现令人安心。