| Budget Amount *help |
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1986: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1985: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Research Abstract |
The aim of the present study was to evaluate the function and morphological change of heterotopic autotransolanted pancreas which was denervated and secreted its hormons into the systemic circulation instead of the portal system. A 62 years old patient had undergone total pancreatectomy for pancreas cancer and autotransplantation of the distal half of pancreas by anastomosis of the splenic vessels to the branches of femoral vessels. The autotransplanted pancreas was normal in histology. Postoperatively, his carbohydrate metabolism was maintained normally and IV-GTT test showed normal blood glucose levels as well as that done preoperatively, though IRI response was impaired with abscence of an early secretory peak. Also the pancreatic exocrine secretion from the external fistula did not decrease in volume and in amylase concentration. However, when he died at the 6th postoperative month, the pancreas consisted of inter- and intra-lobular fibrosis, acinar atrophy, and hypertrophic islets
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. Another patient, 50 years old man with unresectable pancreatic cancer, excreted a 30-92g of urine sugar daily. In order to improve his impaired carbohydrate metabolism, the distal a third of pancreas with severe chronic pancreatitis was resected and autotransplanted at his thigh. Following the operation, his daily urinary glucose output decreased to 0-10g during the first post-operative two weeks and then disappeared. However, IV-GTT was not improved. Experimental studies demonstrated that peripheral insulin levels after glucose load in the dogs which received heterotopic autotransplantaion of the left limb of pancreas following total pancretectomy were higher, though not significantly in statistics, than those in the control in which the right limb of pancreas was removed. However, it remains to be unresolved whether denervation may be responsible for the higher level of peripheral insulin in the animals with autotransplanted pancreas. Based on these observations, it is concluded that heterotopic autotranasplanted pancreas may offer some advantage in the carbohydrate control over the non-transplanted one. Less
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