[The effect of duodenum-preserving pancreatic head resection on the endocrine pancreas function in patients with chronic head pancreatitis].
In a prospective clinical-experimental study, 15 patients with chronic pancreatitis operated consecutively due to severe pain were examined for the effects of a duodenum-preserving resection of the pancreas head on endocrine pancreas function. This was done by means of oral and intravenous glucose tolerance testing before the operation, on the 10th or 11th postoperative day, and three months after the operation. In addition to glucose levels in the peripheral venous blood, levels of insulin, C-peptide, glucagon, somatostatin, and pancreatic polypeptide were determined. As indicated by the k-value, glucose tolerance improved postoperatively in 11 patients; two patients showed no change, and one patient was worse. Only one patient developed evident diabetes mellitus immediately postoperatively. The pre- and postoperative levels of insulin and C-peptide showed no significant differences. The fasting levels of glucagon were significantly lower postoperatively than before the operation (2p less than 0.01). Duodenum-preserving pancreas head resection led to improvement of the glucose tolerance in the majority of patients; a deterioration was observed only in two cases.
Abteilung für Allgemeine Chirurgie, Universität Ulm.
R
R
Bittner
M
M
Büchler
M
M
Butters
B
B
Leibl
S
S
Nägele
R
R
Roscher
H G
HG
Beger
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007515:Islets of Langerhans / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010191:Pancreatic Polypeptide / Q000097:blood; D010195:Pancreatitis / Q000601:surgery*; D011446:Prospective Studies; D013004:Somatostatin / Q000097:blood
D007328:Insulin; D013004:Somatostatin; D010191:Pancreatic Polypeptide; D002097:C-Reactive Protein; D005934:Glucagon
Der Einfluss der duodenumerhaltenden Pankreaskopfresektion (DPKR) auf die endokrine Pankreasfunktion bei Patienten mit chronischer Kopfpankreatitis.