Analysis of postoperative pancreatitis in DSRS with SPD.
OBJECTIVE
Distal splenorenal shunt with splenopancreatic disconnection (DSRS + SPD) evolved to prevent the development of a pancreatic siphon, to improve maintenance as well as quality of portal perfusion and to achieve better long-term survival. We report several cases of postoperative pancreatitis in DSRS + SPD. Recently, oxygen-derived free radicals have been reported to play an important role in pathogenesis of acute pancreatitis.


METHODS
In this study, ten cases of DSRS + SPD were examined intraoperatively. The local changes in oxygen-derived free radicals were obtained by measuring lipid peroxide and an endogenous scavenger (SOD) in the development of DSRS + SPD-induced pancreatitis.


RESULTS
Lipid peroxide activity as the offense system was not changed before or after SPD. However, SOD activity as a defense system was significantly lowered after SPD compared to before SPD.


CONCLUSIONS
These results indicate that an imbalance of both systems might be the cause of postoperative pancreatitis.
Hashimoto
N
N
Kinki University, School of Medicine, Second Department of Surgery, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-0014, Japan.
Ashida
H
H
D000208:Acute Disease; D000681:Amylases / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000601:surgery*; D006801:Humans; D008049:Lipase / Q000097:blood; D008054:Lipid Peroxides / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery*; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D017382:Reactive Oxygen Species / Q000097:blood*; D013164:Splenorenal Shunt, Surgical / Q000379:methods*; D013482:Superoxide Dismutase / Q000097:blood
D008054:Lipid Peroxides; D017382:Reactive Oxygen Species; D013482:Superoxide Dismutase; D008049:Lipase; D000681:Amylases