Clinical and metabolic response to radical distal pancreatectomy for chronic pancreatitis

Wd, Warren; Leite, Cléber Aparecido; Baumeister, F. A. M.; Poucher, Russel; Kalser, Martin H.

doi:10.1016/0002-9610(67)90260-7

Cited by 18 publications

(11 citation statements)

References 6 publications

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“…After pancreaticoduodenectomy for chronic pancreatitis, diabetes occurred in up to 40% of cases. 36 When the resection of pancreatic parenchyma was only 20-30%, as described by Beger et al 37 in duodenum-preserving pancreatectomy, the glucose mechanism remained essentially unchanged but increased to 3.7% in patients operated on for chronic pancreatitis. B€ uchler et al…”

Section: Discussionmentioning

confidence: 87%

“…When pancreaticoduodenectomy is performed on normal pancreatic parenchyma without preexisting diabetes, the incidence of postoperative diabetes ranges from 0% to 10%. [33][34][35] In a series of 253 patients operated on for periampullary cancer, Warren et al 36 reported an incidence of diabetes of 15% after the operation. After pancreaticoduodenectomy for chronic pancreatitis, diabetes occurred in up to 40% of cases.…”

Section: Discussionmentioning

confidence: 98%

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Central Pancreatectomy Revisited

Roggin

Rudloff

Blumgart

et al. 2006

Journal of Gastrointestinal Surgery

102

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Central Pancreatectomy Revisited

Roggin

Rudloff

Blumgart

et al. 2006

Journal of Gastrointestinal Surgery

102

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“…The results indicate that the hormonal secretory capacity of these dogs was influenced by the hormone-containing functional mass rather than the weight of the pancreas itself after surgery and that the uneven distribution of glucagon in the pancreas (predominantly concentrated in the tail of the pancreas) should be taken into consideration when discussing hormonal deficiency after pancreatectomy. Diabetes 38:861-67, 1989 P ancreatic resection has recently been widely used for treating patients who have benign pancreatic diseases and pancreatic malignancies, and with improvement in surgical techniques, several complete cures have been reported (1)(2)(3). However, endocrine deficiency as a result of reduced pancreatic mass is a phenomenon that is not fully understood.…”

mentioning

confidence: 99%

Insulin and Glucagon Secretion After Pancreatectomies Correlation of Secretion and Hormonal Contents of Remaining Pancreas

Gotoh

Monden²,

Okamura³

et al. 1989

Diabetes

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We studied whether insulin and glucagon secretory capacities change in relation to the corresponding hormonal contents in the pancreas remnant after pancreas resection. The following groups of dogs were used: sham operated (S-O), left pancreatectomized (L-Px), right pancreatectomized (R-Px), subtotal pancreatectomized (St-Px), and total pancreatectomized (T-Px). Endocrine functions were assessed by intravenous glucose tolerance test (IVGTT) and insulin tolerance test (ITT) in each dog under anesthesia before surgery and 1 wk after. In these five groups, the insulin secretory capacities, assessed as the integrated incremental secretion of immunoreactive insulin (sigma delta IRI) from the IVGTT, decreased to 95 +/- 11, 78 +/- 9, 48 +/- 8, 12 +/- 8, and -4 +/- 4% of the respective preoperative values, and these values were proportional to the percentage residual weight (100, 64 +/- 2, 35 +/- 2, 13 +/- 2, 0%) and IRI content (100, 59 +/- 4, 45 +/- 3, 10 +/- 2, 0%) of the pancreas remnant. After surgery, glucagon secretory capacity, the integrated incremental secretion of immunoreactive glucagon (sigma delta IRG) during the ITT, decreased significantly in the L-Px, St-Px, and T-Px groups but not in the R-Px group. The sigma delta IRG values as percentages of the preoperative values were 109 +/- 25, 46 +/- 11, 89 +/- 13, 19 +/- 11, and 3 +/- 3%, respectively, for the five groups. These values were proportional to the percentage residual IRG contents of the pancreas remnants (100, 48 +/- 6, 65 +/- 8, 12 +/- 2, 0%) rather than to the percentage residual pancreatic weights.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…In den Berichten von Warren und Mitarbeitern [62,63], Cuilleret und Mitarbeitern [64,65], Leger et al [66] und Trede et al [67] fand sich bei Patienten mit einer chronischen Pankreatitis, die sich einer klassischen Whipple-Operation unterzogen hatten, eine nicht zu vernachlässigende Morbidität von 20-50% in der postoperativen Phase. Diese beruht zum einen auf den chirurgischen Spät-komplikationen wie peptische Ulzera, aszendierende Cholangitiden oder Gallengangstenosen im Bereich der biliodigestiven Anastomose und endokriner Insuffizienz aufgrund zu geringem Pankreasrestgewebe.…”

Section: Langzeitprognose Nach Chirurgischer Therapie Der Chronischenunclassified

Chirurgische Therapie bei der chronischen Pankreatitis

Ketterer¹,

Z’graggen²,

Tempia-Caliera³

et al. 2004

Visc Med

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Surgical Treatment of Chronic Pancreatitis Chronic pancreatitis is characterized by recurrent episodes of pancreatitis and a chronic pain syndrome. The pancreatic structure becomes more and more fibrotic, and the patients suffer from exocrine and endocrine pancreatic insufficiency. The pathogenesis of the pain is based on the release of inflammatory cytokines, changes of the sensory nerves, and an increase of the intraductal and parenchymal pressures in the pancreas. The surgical therapy consists of drainage operations and/or pancreatic resections. In the last decade organpreserving operations such as the duodenum-preserving pancreatic head resection has evolved. Prospective studies demonstrated better results for duodenum-preserving pancreatic head resection in terms of quality of life and endocrine function. After modern pancreatic surgery, up to 90% of the patients are free of pain, and over 70% sustain a normal quality of life index.

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Clinical and metabolic response to radical distal pancreatectomy for chronic pancreatitis

Cited by 18 publications

References 6 publications

Central Pancreatectomy Revisited

Central Pancreatectomy Revisited

Insulin and Glucagon Secretion After Pancreatectomies Correlation of Secretion and Hormonal Contents of Remaining Pancreas

Chirurgische Therapie bei der chronischen Pankreatitis

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