[Experimental studies of the significance of pancreatico-enterostomy on the chronic pancreatitis].
Little is known about endocrine function of the pancreas after it was treated with pancreatico-enterostomy for its chronic inflammation. In order to study this, an experimental model of chronic pancreatitis was made by ligating the canine main pancreatic duct, which was reconstructed eight weeks later by performing pancreatico-duodenostomy in the study group. Pancreatic endocrine function was studied before ligating the main pancreatic duct, 4, 8, 12, and 16 weeks after the ligation in the control group, or 4 and 8 weeks after the reconstruction in the study group. Histological changes of the whole pancreas were also examined when animal was sacrificed. The results of our study are as follows. 1) The endocrine function, which was studied by using IVGTT and calculating K-values, showed significant deterioration eight weeks after the main pancreatic duct ligation. 2) The endocrine function was significantly recovered eight weeks after the reconstruction. 3) Histological evidence of chronic pancreatitis was demonstrated 8 weeks after the main pancreatic duct ligation which was progressed to acinus loss and fibrosis after 16 weeks. The islets of Langerhans were shown to be structurally preserved 8 weeks after the ligation, but ultrastructural alternations 16 weeks after the ligation included apparent degeneration of islet cells. 4) Compared with the control group, fibrotic change of the pancreas was restrained and most of islets did not show degeneration 8 weeks after the reconstruction in the study group. 5) These results suggest that early surgical intervention is to be warranted for chronic pancreatitis, in order to preserve and recover the endocrine function.
Second Department of Surgery, Hokkaido University, School of Medicine, Sapporo, Japan.
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Miyasaka
D000818:Animals; D002908:Chronic Disease; D004285:Dogs; D004766:Enterostomy; D007515:Islets of Langerhans / Q000378:metabolism / Q000473:pathology; D008026:Ligation; D010179:Pancreas / Q000601:surgery*; D010183:Pancreatic Ducts / Q000601:surgery; D010195:Pancreatitis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*