Usefulness of dynamic magnetic resonance pancreatography with secretin [correction of secretion] injection for evaluating pancreatic exocrine function after pancreatogastric reconstructive surgery.
OBJECTIVE
The usefulness of dynamic magnetic resonance pancreatography (MRP) with secretin injection as a new method of assessing pancreatic exocrine function was evaluated in patients undergoing pancreatogastrostomy.


METHODS
A series of 12 patients who had undergone pancreatogastrostomy were classified into group 1 (9 patients whose pancreas was normal preoperatively) and group 2 (3 patients with a firm pancreas accompanied by distended pancreatic ducts). The pancreatic exocrine function was evaluated using the changes in maximum pancreatic duct diameter and the intensity ratio calculated by tracing the contour line on the images of pancreatic juice secretion newly occurring after dynamic MRP with prior secretin injection.


RESULTS
Clear visualization of the pancreatic duct by MRP was achieved in all 12 patients, and a decrease in pancreatic duct diameter was evident postoperatively in group 2. Pancreatic juice secretion was well visualized on MRP images following secretin injection in 10 patients but not in 2 patients of group 2. Higher intensity ratios were noted in group 1 than in group 2.


CONCLUSIONS
Dynamic MRP with secretion injection enables clear verification of pancreatic juice secretion on images and permits objective evaluation of pancreatic exocrine function. It therefore is a useful procedure for assessing pancreatic exocrine function after resection of the pancreas.
Ohhigashi
Seiji
S
Department of Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
Watanabe
Fumihiko
F
D000328:Adult; D000368:Aged; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000033:anatomy & histology / Q000502:physiology* / Q000601:surgery; D010183:Pancreatic Ducts / Q000033:anatomy & histology; D010189:Pancreatic Juice / Q000378:metabolism; D012633:Secretin
D012633:Secretin