1993 Fiscal Year Final Research Report Summary
Experimental study on the evaluation of organ relationship and prospect of the upper limit of resection in simultaneous massive hepato-pancreatectomy
| Project/Area Number |
04670800
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kitasato Univ.School of Medicine |
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Principal Investigator |
OMIYA Harumi Dept.of Surg.associate prof, 医学部, 助教授 (70050557)
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| Co-Investigator(Kenkyū-buntansha) |
FURUTA K Dept.of Surg.assistant, 医学部, 助手 (40209177)
IZUMIKA H Dept.of Surg.assistant, 医学部, 助手 (30193379)
TAKAHASHI T Dept.of Surg.assist.Prof, 医学部, 講師 (70245405)
YOSHIDA M Dept.of Surg.assist.Prof, 医学部, 講師 (50201017)
KAKITA A Dept.of Surg.professor, 医学部, 教授 (90109439)
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| Project Period (FY) |
1992 – 1993
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| Keywords | hepatectomy / pancreatectomy / massive hepato-pancreatectomy / organ-relationship / Hepatc regenertion / pancreatic hormone |
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| Research Abstract |
The nesessity of massie hepato-pancreatectomy to imporove the curability of hepatobiliary malignancies has been adovocated, and many clinical cases have been reported. However, the pathohysioogy of the early postoperative stage of those patients remains still unclear. So we planned an experimental study of massive hepato-pancreatectomy using adult mongrel dogs.
The results were as folloes.
(1) In controll group(G1), in which 70% hepatectomy without pancreatectomy was performed, survival rate up to 4 weeks was 100%. In group2, 70% hepatectomy with 66.7% pancreatectomy, survival rate was 66.7%. In Group3, 70% hepatectomy with 80% pancreatectomy, survival rate was 75%. The major cause of death was hepatic failure. The early postoperative thrombocytepenia, prolongation of PTT or HT, and delay of those data seeed to be the important indcatior of hepatic failure. The early decrease of IRI and rise of IRG and blood sugar also indicative of impending hepatic failure.
(2) The reqenerative ratio of the liver in survived cases were 85.3% in G1, 96.3% in Gi, 65.2% in G3. But there were no significant difference in the hepatic functin nor pancreatic endocrine functions amaong three groups up to 4 weeks after operation.
In order to make it possible to apply these operations safely inthe clinical cases, further investigation on early postoperative pathohysiology such as follows are inevitable.
1. To evauate invasiveness of the operation, we are going to make the standarization of the indicator of invasiveness(including such as TNF or osmolarity gap).
2. To study about the effect of mssive heato-pancreatectomy on the regeneration of the liver and pancreas through the study of regenerative factors including pancreatic hormones and the morphological study of resected liver and pancreas together with that of regenerated liver and pancreas.
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