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PubMed1975

Replacement of portal vein during pancreatectomy for carcinoma.

Three patients are described in whom the portal vein, surrounded but not penetrated by pancreatic carcinoma, was resected and replaced by an expanded Teflon (Gore-Tex) tube. One patient, who has survived 32 months without recurrence of disease, had a radiographically patent graft at 2 and 17 months after operation. A second survivor has a patent graft at 8 months. The third patient died 10 days after operation with an open prosthesis. Excision of involved portal vein during pancreatoduodenectomy for carcinoma of the pancreas is justified in the absence of metastases. Vein grafting is the best means of portal vein reconstruction. Gore-Tex appears to be a suitable prosthesis when the portal vein must be sacrificed. Its clinical success in terms of patency substantiates previous experience in experimental animals.

Adenocarcinoma↗
PubMedDate not supplied

Successful partial transplant pancreatectomy with end-to-side duct-to-ureter anastomosis: salvage of a pancreatic allograft.

Segmental pancreatic transplantation has been abandoned because of the high incidence of technical complications. We report the first case in the literature of the salvage of a partially ischemic pancreatic allograft. The procedure consisted of resecting the head of the pancreas and draining the residual segment to the ureter with a duct-to-ureter end-to-side anastomosis. The postoperative course was uneventful, and 15 months after surgery graft function is satisfactory with a urinary amylase level of 5000 U/h. The duct-to-ureter drainage technique should be part of every transplant surgeon's repertoire, because in emergency situations like the one described, it can be used to save a pancreatic allograft.

Adult↗
PubMed1975

The influence of fasting and pancreatectomy on some glycolytic enzymes in the muscle of garden lizard, Calotes versicolor.

The leg muscle of Calotes versicolor consists mainly of white fibers. They can be classified into small, intermediate and broad fibers according to their diameter and staining reaction. The histochemical study of some of the glycolytic enzymes such as aldolase, phosphorylase, lactic dehydrogenase (LDH) and alpha-glycerophosphate dehydrogenase (alpha-GPDH) is described in the muscle of normal, pancreactomized and insulin injected animals. Highest activity of all enzymes was observed in the small fibers, though they occur in negligiable amount (3%). The intermediate and broad fibers exhibited medial and lowest activities respectively. 24 h after the extirpation of the pancreas a considerable inhibition is noted in the activities of phosphorylase, LDH and alpha-GPDH. Induced inanition for 21 days ensued insignificant but gradual decrease and increase in the alpha-GPDH and phosphorylase activities respectively in both unoperated and operated animals. The aldolase shows its mere presence in normal and trace activity in pancreatectomized animals. The injection of insulin (40 i.u./kg) at the interval of 30 min, 60 min, 4 h, 12 h and 24 h is given. The activities of all enzymes is stimulated at 30 min and depleted 4 h after the injection. The level of activity was remaintained at 12 h to 24 h stage. The possible physiological role and significance of enzymes in the synthesis and breakdown of glycogen is discussed.

Animals↗
PubMedDate not supplied

Mucinous cystic lesions of the pancreas. Report of a patient submitted to distal pancreatectomy.

Intraductal papillary neoplasm consists a variant of the mucin-producing neoplasms of the pancreas; these are rare diseases that can be divided into mucinous ductal ectasias and intraductal papillary neoplasms. Such neoplasms have a malignant potential, and their prognosis is good if they are early diagnosed and localized surgical resection. This paper describes a case of an intraductal papillary neoplasm localized in the tail of the pancreas and treated by distal splenopancreatectomy. The literature on this rare disease is also reviewed.

Female↗
PubMedDate not supplied

Prediction of pancreatic fistula by amylase levels of drainage fluid on the first day after pancreatectomy.

BACKGROUND/AIMS: We investigated whether it would be useful to monitor amylase levels of drainage fluid after pancreatic surgery for prediction of pancreatic fistula. METHODOLOGY: Twenty-six cases in which amylase levels of drainage fluid were determined after pancreatic surgery, were divided into 14 cases who did not develop pancreatic fistula and 12 cases who developed pancreatic fistula. Changes in amylase levels of sera and urine as well as drainage fluid were monitored. RESULTS: Amylase levels of drainage fluid were significantly higher in cases with pancreatic fistula than in cases without pancreatic fistula on the first postoperative day, but those levels in both groups decreased until the 7th postoperative day without significant difference. However, those levels in cases with pancreatic fistula significantly increased from the 9th postoperative day whereas the levels in cases without pancreatic fistula further decreased. There was no significant difference in amylase levels of sera or urine. CONCLUSIONS: Amylase levels of drainage fluid on the first postoperative day may be useful to predict development of pancreatic fistula and to plan appropriate management.

Aged↗
PubMedDate not supplied

[Duodeno-pancreatectomies].

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Digestive System Surgical Procedures↗