Suda K, Takei K, Suzuki F, Kamano T, Yamane T
Department of Pathology, Juntendo University School of Medicine, Tokyo, Japan.
J Clin Gastroenterol. 1997 Oct;25(3):546-9. doi: 10.1097/00004836-199710000-00015.
In autopsy specimens removed after gastrectomy from patients who had survived for 2.5 to 40 years after surgery, we found hyalinization of the islets of Langerhans in 9 of 15 cases (60%) with Billroth's I anastomosis (B-I) and in 8 of 16 cases (50%) with Billroth's II anastomosis (B-II). The hyalinization in the postgastrectomy patients was significantly increased compared with that in controls (p < 0.01). The percentage of hyalinized islets of Langerhans in the 17 cases showing hyalinization ranged from 0.2% to 14.3%. The percentage increased relative to the period after gastrectomy in the B-I patients but not in those with B-II. The blood glucose level was mildly elevated in three B-I patients, whereas it was increased in only one patient with B-II. Hyalinization of the islets of Langerhans may be due to vagotomy or to excessive stimulus and hyperactivation of the islets. In any event, the islets of Langerhans in patients after gastrectomy were frequently replaced by hyalinization, which might cause impaired glucose tolerance.
在胃切除术后存活2.5至40年的患者尸检标本中，我们发现15例采用毕罗I式吻合术（B-I）的患者中有9例（60%）出现胰岛玻璃样变，16例采用毕罗II式吻合术（B-II）的患者中有8例（50%）出现胰岛玻璃样变。与对照组相比，胃切除术后患者的玻璃样变显著增加（p < 0.01）。在17例出现玻璃样变的病例中，胰岛玻璃样变的百分比在0.2%至14.3%之间。B-I患者中胰岛玻璃样变的百分比相对于胃切除术后的时间有所增加，而B-II患者则没有。3例B-I患者血糖水平轻度升高，而B-II患者中只有1例血糖升高。胰岛玻璃样变可能是由于迷走神经切断术或胰岛受到过度刺激和过度激活所致。无论如何，胃切除术后患者的胰岛常被玻璃样变取代，这可能导致糖耐量受损。
