Experimental and Clinical Studies on Transplantation of the Pancreas

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Experimental and clinical studies on pancreatic transplantation conducted at the 2nd Department of Surgery for the last 3 years were reported.A) Experimental studies1) Did transplanted pancreatic islets from chronic pancreatitis maintain normal glucose levels in dogs?Chronic pancreatitis was induced by injection of Freund's' complete adjuvant in 12 mongrel dogs. They were totally pancreatomized, and then all islet cells of the each dog were transplanted into the splenic pulp ofd the each dog respectively. The endocrine funcion was disturbed soon after islet transplantation in the dogs with severe fibrosis of the pancreas and the glucose level did not maintain normal.2) Was it necessary to drain the pancreatic ductal system in the dogs with segmental pancreas transplantation?Segmental pancreas transplantation with pancreaticojejunostomy or pancreatico-cystostomy after total pancreatectomy was done on 11 dogs. All dogs showed normal endocrine function for a long time without pancreatic f … More ibrosis. Although segmental pancreas transplantation with intraperitoneal drainage or duct occlusion using neoprene was done on 8 dogs, all dogs showed progressive disturbance of pancreatic function with severe fibroses .3) How to prevent throbosis of the splenic vein in the dogs with segmental pancreas transplantation?Segmental pancreas transplantation accompanied with spleen or splenic arteriovenous shunt without spleen was done an 15 dogs. In thase dogs. No Vasccelar thrcmbosis was seen. Although segfmental transplantation without spleen or arteriovenous shunt was done on 8 dogs, 50 of the dogs had vascular thrombosis and resulted in graft failure.B) Clinical studies.On the basis of those experimental results, pancreas islet autotransplantation and segmental pancreatic autograft were clinically done on 4 patients with chronic pancreatitis and 5 patients with pancreatoduodenal cancer. Four patients with chronic pancreatitis underwent subtotal distal pancreatectomy with islet transplantation and 3 with pancreatoduodenal cancer underwent total pancreatectomy with islet transplantation. One patient with carcinoma of the pancreas received segmental pancreatic autograft after total pancreatectomy with spleen and one patient without spleen.Postoperative pancreatic endocrine function was examined in 7 patients with islet transplantation. It was disturbed gradually in 5 patients and unchanged in 2 as compared with their preoperative function. In 2 patients with segmental pancreas autograft, one lost pancreatic autograft due to splenic venous thrombosis, and another is alive with normal pancreatic function after operation. Less