1987 Fiscal Year Final Research Report Summary
Studies on Promotion of Regeneration of the Remnant Pancreas after Major Pancreatectomy
| Project/Area Number |
60480301
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kyoto University (1985-1986, 1988)
Yamaguchi University (1987) |
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Principal Investigator |
SUZUKI Takashi Yamaguchi Univ. Med. School, Professor, 医学部, 教授 (20026834)
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| Co-Investigator(Kenkyū-buntansha) |
MIYASHITA Tadashi Kyoto Univ. Med. School, Lecturer, 医学部, 助手 (80182020)
MANABE Tadao Kyoto Univ. Med. School, Assistant Professor, 医学部, 講師 (80127141)
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| Project Period (FY) |
1985 – 1987
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| Keywords | Pancreatic cancer / Pancreatectomy / Pancreatic regeneration / Trypsin inhibitor / Vagotomy / Sympathectomy / CCK |
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| Research Abstract |
Improvement of the pancreatic endocrine and exocrine disorders following major pancreatectomy is a major problem. Impairments of the glucose elimination rate and the exocrine pancreas after 85 percent pancreatectomy were improved by means of oral administration of a synthetic trypsin inhibitor for 4 and 12 weeks,and a significant enlargement of the remnant pancreatic tissue was brought about.
Clinically,the radical operation of pancreativ cancer, such as extended pancreaticoduodenectomy, is often accompanied with trucal vagotomy or celiac ganglionectomy. The following experiments were designed in order to define the effect of truncal vagotomy (TV) or celiac ganglionectomy (CG) on the pancreativ trophic action of oral administration of synthetic trypsin inhibitor (o-TI). In the first step, male Wister rats were divided into two groups: 1) non-pancreatectomized group. 2) major pancreatectomized (85%) group. In the second step, these two groups were subdivided into four groups: a) Control
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group (laparotomy only), b) o-TI only, c) o-TI + TV, d) o-TI +CG. After 6 weeks from the operation, rats were sacrificed. Pancreatic weight (PW), DNA, RNA, and protein contents in pancreatic tissue were measured and compared.As a resu- It, meither turncal vagotomy nor celiac ganglionectomy had a significant effect on trophic action of trypsin inhibitor upon both the nonpancreatectomized pancreas after major pancreatectomy. CCK could exert an important role for the modulation of the function of the remnant pancreas even after pancreatoduodenal resection, but no information is available as to whether CCK is released into circulation after pancreatoduodenectomy, which removes the main sources of release of CCK. The last study was conducted to elucidate plasma cholecystokinin (CCK) response after pancreatoduodenectomy and to compare response of CCK in patients who had pancreatoduodenectomy with Billroth I and Billroth II type of reconstruction. Basal levels of plasma CCK were significantly lower in patients who had pancreatoduodenectomy than in the control probably because of the removal of the entire duodenum due to pancreatoduodenectomy, since vagotomy, which is concomitantly brought about by pancreatoduodenectomy, does not appear to interfere with release of CCK. Significant amounts of CCK, although less amounts than in the preoperative patients were still released in response to oral fatty meal after pancreatoduodenectomy. Plasma CCK response to oral fatty meal was significantly greater in patients who had pancreatoduodenectomy with Billroth I type of reconstruction than in patients who had pancreatoduodenectomy Billroth II type of reconstruction. Thus, Billroth I type of anastomosis as a physiologic reconstruction procedure for the remnant alimentary tract after pancreatoduodenectomy,is usefu for promotion of regemeration of the remnant pancreas after major pancreatectomy. Less
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