Okushiba T
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1993 May;68(3):391-406.
The remnant pancreatic function after surgery of the pancreas has hitherto been extensively studied. Nevertheless much still remains unknown. The significances of pancreatico-enterostomy on the chronic pancreatitis, especially in reference to changes of the endocrine function and histology in remnant pancreas, were studied. An experimental chronic pancreatitis model was made by ligation and division of the main pancreatic duct, which was followed by 50% pancreatectomy (Resection group) and by reconstruction of pancreatic duct with 50% pancreatectomy (reconstruction group) at 8 weeks. The results were as follows. 1) The pancreatic endocrine function, which was studied by using IVGTT, and calculated by K-values, showed significant deterioration 8 weeks after the main pancreatic duct ligation. 2) The remnant pancreatic endocrine function of reconstruction group was significantly recovered 16 weeks after 50% pancreatectomy as compared to resection group. 3) On the histological study, fibrosis of the reconstruction group was restrained and inflammatory cells were disappeared. 4) These results suggest that early operative intervention should be done as a treatment of chronic pancreatitis with 50% pancreatectomy, in order to preserve and recover the eccrine function.
迄今为止，胰腺手术后残余胰腺功能已得到广泛研究。然而，仍有许多未知之处。本研究探讨了胰肠吻合术对慢性胰腺炎的意义，特别是对残余胰腺内分泌功能和组织学变化的影响。通过结扎和切断主胰管建立实验性慢性胰腺炎模型，8周后行50%胰腺切除术（切除组）及50%胰腺切除术后胰管重建术（重建组）。结果如下：1）采用静脉葡萄糖耐量试验（IVGTT）研究并通过K值计算的胰腺内分泌功能，在主胰管结扎8周后显著恶化。2）与切除组相比，重建组在50%胰腺切除术后16周残余胰腺内分泌功能显著恢复。3）组织学研究显示，重建组纤维化得到抑制，炎症细胞消失。4）这些结果表明，对于慢性胰腺炎患者，应尽早进行手术干预并行50%胰腺切除术，以保留和恢复外分泌功能。
