Sho M, Nakajima Y, Kanehiro H, Hisanaga M, Nishio K, Nagao M, Tatekawa Y, Ikeda N, Kanokogi H, Yamada T, Hirohashi S, Hirohashi R, Uchida H, Nakano H
First Department of Surgery, Nara Medical University, Kashihara, Japan.
Am J Surg. 1998 Sep;176(3):279-82. doi: 10.1016/s0002-9610(98)00148-2.
The remnant pancreatic function after pancreatoduodenectomy influences greatly postoperative quality of life. However, it has been difficult to evaluate the exocrine remnant pancreatic function postoperatively. The aim of this study was to assess the usefulness of secretin-stimulated magnetic resonance cholangiopancreatography (secretin MRCP) in evaluating the remnant pancreatic function and ascertaining the anastomotic patency after pancreatoduodenectomy.
Thirty-four patients who underwent pancreatoduodenectomy were evaluated with secretin MRCP. The results of MRCP were determined by the amount of exocrine pancreatic secretion, and were graded as follows: grade I (poor secretion), grade II (moderate secretion), and grade III (good secretion).
Secretin MRCP could visualize the pancreatic secretion dynamically. MRCP grades were grade I in 11 patients, grade II in 12, and grade III in 11. There was a significant correlation between MRCP grade and glucose tolerance. We confirmed visually the patency of the anastomotic site in 24 patients (71%). MRCP grades correlated significantly with clinical symptoms.
Our results demonstrated secretin MRCP was feasible for evaluating the remnant pancreatic function after pancreatoduodenectomy.
胰十二指肠切除术后残余胰腺功能对术后生活质量有很大影响。然而，术后评估胰腺外分泌残余功能一直很困难。本研究的目的是评估促胰液素刺激磁共振胰胆管造影（促胰液素MRCP）在评估胰十二指肠切除术后残余胰腺功能及确定吻合口通畅性方面的实用性。
对34例行胰十二指肠切除术的患者进行促胰液素MRCP评估。MRCP结果根据胰腺外分泌量确定，并分为以下等级：I级（分泌不良）、II级（分泌中等）和III级（分泌良好）。
促胰液素MRCP可动态观察胰腺分泌情况。MRCP分级为I级的患者有11例，II级12例，III级11例。MRCP分级与糖耐量之间存在显著相关性。我们在24例患者（71%）中直观确认了吻合口部位的通畅性。MRCP分级与临床症状显著相关。
我们的结果表明，促胰液素MRCP对于评估胰十二指肠切除术后残余胰腺功能是可行的。
