A new evaluation of pancreatic function after pancreatoduodenectomy using secretin magnetic resonance cholangiopancreatography.
BACKGROUND
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
Our results demonstrated secretin MRCP was feasible for evaluating the remnant pancreatic function after pancreatoduodenectomy.
First Department of Surgery, Nara Medical University, Kashihara, Japan.
M
M
Sho
Y
Y
Nakajima
H
H
Kanehiro
M
M
Hisanaga
K
K
Nishio
M
M
Nagao
Y
Y
Tatekawa
N
N
Ikeda
H
H
Kanokogi
T
T
Yamada
S
S
Hirohashi
R
R
Hirohashi
H
H
Uchida
H
H
Nakano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology* / Q000503:physiopathology*; D010186:Pancreatic Function Tests / Q000379:methods*; D016577:Pancreaticoduodenectomy; D011184:Postoperative Period; D012633:Secretin; D013997:Time Factors
D012633:Secretin