Promotion of regeneration of remnant pancreas after pancreatectomy and modification of pylorus-preserving procedure

1.研究了蛋白酶抑制剂（P.I.）对大鼠部分胰腺切除术后残余胰腺变化的可逆性。选取雄性Wistar大鼠40只，分为开腹后水处理组、开腹后灌胃组、胰切除术后水处理组和胰切除术后灌胃组。在II组和IV组，卡莫他（200mg/kg/天）通过胃管给予，每天7天。II组和IV组66%行远端胰腺切除术，切除胃段和脾段。给药后胰腺重量和组织蛋白含量显著增加，胰腺腺泡细胞肥大。在IV组中，这些参数的增加更大，并在停止p.i.治疗后持续四周。在第二组，伤寒变化是可逆的，并在最后一次p.i.治疗后7天内迅速停止。P. ...由此可以推断，与正常胰腺相比，残肢胰腺中i诱导的营养效应更大，持续时间更长。为了探讨保幽门胰十二指肠切除术（PPPD）后早期胃排空延迟的病因，我们采用对乙酰氨基酚法研究了迷走神经幽门支分离和十二指肠横断对大鼠胃排空的影响。这些动物被分为以下四组。1、C组；羞耻手术2例，N组；迷走神经幽门分支，3，D组；4、N+D组；幽门失神经支配及十二指肠横断。我们追踪四组患者术后1、2、4周胃排空的连续变化，并对结果进行比较。因此，PPPD期间幽门神经血管供应的分裂和/或十二指肠的横断，导致术后胃排空延迟，但随后恢复。我们研究了在壶腹周围癌PPPD中，在保留肠系膜上神经丛（PLsma）的同时切除区域淋巴结的程度。淋巴结均匀分布于肠系膜上动脉（SMA）左右半圆及纵轴。在142个淋巴结中，134个（94.4%）位于PLsma外。在保留肠系膜上神经丛的同时，理论上可以切除肠系膜上淋巴结。少

1.Examination was made of the reversibility of pancreatic changes induced by the protease inhibitor (P.I.) in remnant pancreas after partial pancreatectomy in rats. Forty male Wistar rats were grouped as group I treated with water after laparotomy, group I treated with P.I.after laparotomy, group II treated with water after pancreatectomy and group IV treated with P.I.after pancreatectomy. In groups II and IV,camostat (200mg/kg/day) was administered daily for seven days via an orogastric tube. In groups II and IV,66% distal pancreatectomy was conducted, in which gastric and splenic segments were removed. Significant increase in pancreatic weight and tissue protein content and hypertrophy of the acinar cells of the pancreas was noted after P.I.administration. In group IV,increase in these parameters was greater and persisted for four weeks after the cessation of P.I.treatment. In group II,tyophic change was reversible and rapidly ceased within seven days after the last P.I.treatment. P. … More I.-induced trophic effect may thus be concluded greater and more prolonged in remnant that in normal pancreas.2.We investigated the effect of dividing the pyloric branch of the vagus nerve and transection of the duodenum on gastric emptying using the acetaminophen method in rats to investigate the etiology of early delayd gastric emptying after pylorus preserving pancreatoduodenectomy (PPPD). The animals were divided into the following four groups. 1, group C ; shame operation, 2, group N ; division of the pyloric branch of the vagus nerve, 3, group D ; transection of the duodenum, and 4, group N+D ; pyloric denervation and doudenal transection. We traced the serial changes in gastric emptying in the four groups at 1,2 and 4 weeks after operations and compared the results. As a result, division of the neurovascular supply to the pylorus and/or transection of the duodenum, that were brought about during PPPD,caused postoperative delayd gastric emptying, which did, however, subsequently recover.3.We examined the extent to which regional lymph nodes may be dissected while preserving the superior mesenterc nerve plexus (PLsma) in PPPD for periampullary cancer. The lymph nodes were distributed uniformly on the right and left hemicircles of the superior mesenteric artery (SMA) and along its longitudinal axis. Of a total of 142 lymph nodes, 134 (94.4%) were located outside the PLsma. Dissection of the superior mesenteric lymph nodes is theoretically to be possible while preserving the supperior mesenteric nerve plexus. Less