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  • Title: Histological loss of pancreatic exocrine cells correlates with pancreatic exocrine function after pancreatic surgery.
    Author: Yuasa Y, Murakami Y, Nakamura H, Uemura K, Ohge H, Sudo T, Hashimoto Y, Nakashima A, Hiyama E, Sueda T.
    Journal: Pancreas; 2012 Aug; 41(6):928-33. PubMed ID: 22781909.
    Abstract:
    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.
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