title: Pancreatic injury after major hepatectomy: a study in a porcine model.
abstract: OBJECTIVE
  The aim of this study was to investigate the pathophysiology of pancreatitis after major hepatectomy.
  
  
  METHODS
  The study used ten female pigs. Three served as sham animals (sham group) and were killed after laparotomy to obtain normal tissue samples. Seven animals were subjected to major hepatectomy (70-75%), using the Pringle maneuver for 150 min, after constructing a portacaval side-to-side anastomosis (hepatectomy group). Duration of reperfusion was 24 h.
  
  
  RESULTS
  Pancreatic tissue sampled 24 h after reperfusion had increased necrosis and edema in comparison to sham group and to tissue sampled at 12 h. Tissue malondialdehyde (MDA) did not differ significantly between samples at 12 and 24 h but was increased in the hepatectomy group in comparison to sham animals. Percentage increase in portal MDA content during reperfusion was greater at 12 h of reperfusion in comparison to the increase after 24 h. Portal pressure increased significantly after 12 h of reperfusion. Serum amylase and C-peptide increased during reperfusion in comparison to baseline levels.
  
  
  CONCLUSIONS
  The findings suggest that intraoperative portal congestion is not the only cause of the development of pancreatitis after major hepatectomy. The oxidative markers suggest that reactive oxygen species produced during vascular control may be responsible as well.
authors.affiliation: Fourth Department of Surgery, School of Medicine, Attikon University Hospital, 1 Rimini Str., 12462, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Nastos
authors.forename: George
authors.initials: G
authors.lastname: Defterevos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalimeris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papoutsidakis
authors.forename: Ioanna
authors.initials: I
authors.lastname: Andreadou
authors.forename: Tzortzis
authors.initials: T
authors.lastname: Nomikos
authors.forename: Agathi
authors.initials: A
authors.lastname: Pafiti
authors.forename: George
authors.initials: G
authors.lastname: Fragulidis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Economou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Varsos
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Vassilios
authors.initials: V
authors.lastname: Smyrniotis
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D015415:Biomarkers; D004195:Disease Models, Animal; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D007249:Inflammation / Q000097:blood; D007813:Laparotomy; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress; D010179:Pancreas / Q000293:injuries*; D010195:Pancreatitis / Q000209:etiology* / Q000473:pathology; D017382:Reactive Oxygen Species; D013552:Swine
chemical_list: D015415:Biomarkers; D017382:Reactive Oxygen Species; D008315:Malondialdehyde
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