Histological loss of pancreatic exocrine cells correlates with pancreatic exocrine function after pancreatic surgery.
OBJECTIVE
The aim of this study was to investigate the relationship between histological findings of the pancreatic stump and postoperative pancreatic exocrine function.


METHODS
One hundred ten patients including 80 patients undergoing pancreatoduodenectomy (PD) and 30 patients undergoing distal pancreatectomy (DP) were enrolled into this study. Postoperative exocrine pancreatic function was evaluated by 13C-labeled mixed triglyceride breath test. The areas of acinar cells, fibrotic tissues, and fatty replacement were histologically calculated in surgical specimens of the pancreatic stump.


RESULTS
Histologically, acinar cell area of patients undergoing PD was significantly less than that of patients undergoing DP (P = 0.025). The values of the mean percentage dose 13C cumulative 7 hours of patients undergoing PD were significantly lower than those of patients undergoing DP (P < 0.001). The rate of pancreatic exocrine insufficiency in patients undergoing PD is significantly higher than that in patients with DP (P = 0.002). There was a significant correlation between acinar cell area of the pancreatic stump and the percentage dose 13C cumulative 7 hours (R = 0.35, P < 0.001).


CONCLUSIONS
Pancreatoduodenectomy induced pancreatic exocrine insufficiency more frequently than DP. Histological loss of acinar cells in the pancreatic stump was strongly correlated with postoperative pancreatic exocrine function.
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. ucf30e53@yahoo.co.jp
Yoshio
Y
Yuasa
Yoshiaki
Y
Murakami
Hiroyuki
H
Nakamura
Kenichiro
K
Uemura
Hiroki
H
Ohge
Takeshi
T
Sudo
Yasushi
Y
Hashimoto
Akira
A
Nakashima
Eiso
E
Hiyama
Taijiro
T
Sueda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D016009:Chi-Square Distribution; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010180:Pancreatectomy / Q000009:adverse effects*; D010186:Pancreatic Function Tests; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism
D014280:Triglycerides