Dormeyer H H, Neher M, Schönborn H, Röhrich H
Dtsch Med Wochenschr. 1979 Nov 23;104(47):1670-3. doi: 10.1055/s-0028-1129168.
A follow-up investigation of 20 patients, surgically treated for acute haemorrhagic necrotising pancreatitis, was performed in an average of 2 3/4 years after the operation. Twelve patients showed manifest diabetes mellitus, four further cases had a suspicious oral glucose tolerance test. Only one patient was insulin dependent. A secretin-pancreozymin test performed in 15 patients showed a dissociated or global pancreatic insufficiency in 13 cases. The extent of the endocrine and exocrine functional disturbance did not correlate with the extent of surgery. Postoperative functional defects were readily improved therapeutically in most cases. Only in patients who continued to consume alcohol were there digestive disturbances. The results indicate that the functional state of the remaining pancreas does not only depend on the extent of surgery but also on the extent of already existing or persisting toxic inflammatory damage and on the regenerative capacity of the remaining parenchyma.
对20例接受手术治疗的急性出血性坏死性胰腺炎患者进行了随访调查，平均随访时间为术后2又3/4年。12例患者表现为明显的糖尿病，另有4例口服葡萄糖耐量试验结果可疑。仅1例患者依赖胰岛素治疗。对15例患者进行的促胰液素-胰酶泌素试验显示，13例存在分离性或全身性胰腺功能不全。内分泌和外分泌功能障碍的程度与手术范围无关。大多数情况下，术后功能缺陷通过治疗很容易得到改善。只有继续饮酒的患者存在消化功能障碍。结果表明，剩余胰腺的功能状态不仅取决于手术范围，还取决于已存在或持续存在的毒性炎症损伤程度以及剩余实质的再生能力。
