Miyata M, Takao T, Okamoto E, Manabe H
Am J Surg. 1977 May;133(5):577-81. doi: 10.1016/0002-9610(77)90012-5.
The effect of pancreatoduodenectomy on insulin secretion was determined in seven patients with periampullary malignant tumors. As a uniform stimulus for secreting insulin, 100 gm of glucose was administered orally to all patients and glucose tolerance tests were carried out. Glucose intolerance and poor insulin secretion were obvious both pre- and postoperatively. Indexes of an initial insulin response, of a maximum insulin increment, and of total secretion of insulin responding to the stimulus of glucose were significantly lower in these patients before and after pancreatoduodenal resection, as compared with normal subjects. It was also observed that these three indexes, which express the ability of the pancreas to secrete insulin, decreased without exception after pancreatoduodenectomy. In light of these data it is postulated that radical pancreatoduodenectomy further diminishes the already insufficient secretion of insulin indicated by the oral glucose tolerance test in patients with periampullary malignant tumors.
在7例壶腹周围恶性肿瘤患者中测定了胰十二指肠切除术对胰岛素分泌的影响。作为分泌胰岛素的统一刺激物，对所有患者口服100克葡萄糖并进行葡萄糖耐量试验。术前和术后葡萄糖不耐受和胰岛素分泌不良均很明显。与正常受试者相比，这些患者在胰十二指肠切除术前和术后，对葡萄糖刺激的初始胰岛素反应、最大胰岛素增量和胰岛素总分泌指标均显著降低。还观察到，这三个表示胰腺分泌胰岛素能力的指标在胰十二指肠切除术后无一例外地下降。根据这些数据推测，根治性胰十二指肠切除术进一步降低了壶腹周围恶性肿瘤患者口服葡萄糖耐量试验所显示的本已不足的胰岛素分泌。
