Heterotopic autotransplantation of segmental pancreas

节段性胰腺异位自体移植

• 批准号: 60570621
• 负责人: MIWA Koichi
• 金额: $ 1.09万
• 依托单位: Kanazawa University (1986)福井医科大学 (1985)
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1985
• 资助国家: 日本
• 起止时间: 1985 至 1986
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-60570621/
• 关键词: Pancreatic transplantation; Diabetes melltus; Total pancreatectomy; Chronic pancreatitis; Insulin; 膵癌

The aim of the present study was to evaluate the function and morphological change of heterotopic autotransolanted pancreas which was denervated and secreted its hormons into the systemic circulation instead of the portal system. A 62 years old patient had undergone total pancreatectomy for pancreas cancer and autotransplantation of the distal half of pancreas by anastomosis of the splenic vessels to the branches of femoral vessels. The autotransplanted pancreas was normal in histology. Postoperatively, his carbohydrate metabolism was maintained normally and IV-GTT test showed normal blood glucose levels as well as that done preoperatively, though IRI response was impaired with abscence of an early secretory peak. Also the pancreatic exocrine secretion from the external fistula did not decrease in volume and in amylase concentration. However, when he died at the 6th postoperative month, the pancreas consisted of inter- and intra-lobular fibrosis, acinar atrophy, and hypertrophic islets … More . Another patient, 50 years old man with unresectable pancreatic cancer, excreted a 30-92g of urine sugar daily. In order to improve his impaired carbohydrate metabolism, the distal a third of pancreas with severe chronic pancreatitis was resected and autotransplanted at his thigh. Following the operation, his daily urinary glucose output decreased to 0-10g during the first post-operative two weeks and then disappeared. However, IV-GTT was not improved. Experimental studies demonstrated that peripheral insulin levels after glucose load in the dogs which received heterotopic autotransplantaion of the left limb of pancreas following total pancretectomy were higher, though not significantly in statistics, than those in the control in which the right limb of pancreas was removed. However, it remains to be unresolved whether denervation may be responsible for the higher level of peripheral insulin in the animals with autotransplanted pancreas. Based on these observations, it is concluded that heterotopic autotranasplanted pancreas may offer some advantage in the carbohydrate control over the non-transplanted one. Less

本研究的目的是评价异位自体移植胰腺的功能和形态变化。本文报告一例62岁的胰腺癌患者行全胰腺切除，行脾血管与股血管分支吻合的自体胰腺远端半段移植。自体移植胰腺组织学正常。术后，他的碳水化合物代谢维持正常，IV-GTT试验显示血糖水平与术前一样正常，尽管IRI反应受损，早期分泌高峰消失。此外，外瘘的胰腺外分泌在体积和淀粉酶浓度方面也没有减少。然而，当他在术后6个月去世时，胰腺由小叶间和小叶内纤维化、腺泡萎缩和肥大的胰岛…组成。更多。另一名患者，50岁，患有无法切除的胰腺癌，每天排出30-92克尿糖。为了改善他受损的碳水化合物代谢，重症慢性胰腺炎患者的远端三分之一的胰腺被切除，并在他的大腿上进行自体移植。术后两周内，患者每日尿糖排出量降至0~10g，随后消失。但IV-GTT未见改善。实验研究表明，全胰腺切除后行左胰腺同种异位自体移植的犬，血糖负荷后的外周胰岛素水平高于切除右胰腺的对照犬，但统计学上无显著差异。然而，去神经是否可能是自体胰腺移植动物外周胰岛素水平升高的原因仍未得到解决。在此基础上，我们得出结论：异位自体移植胰腺在控制糖代谢方面可能比未移植胰腺更具优势。较少

项目成果

MIWA, KOICHI et. al.: "A case of heterotopic autotransplantation of residual distal pancreas following pancreatoduodenectomy." The Japanese Journal of Gastroenterological Surgery.17(10). 1891-1895 (1984)

三轮、小一等。

MIWA, Koichi et. al.: "The function and morphology of heterotopic autotransplanted pancreas." unpublished.

MIWA，Koichi 等。

三輪晃一: 日本消化器外科学会雑誌. 17(10). 1891-1895 (1984)

Koichi Miwa：日本胃肠外科杂志 17(10) 1891-1895 (1984)。

MIWA, Koichi et. al.: "A case report----Improvement of diabetes mellitus following heterotopic autotransplantation of distal pancreas."

MIWA，Koichi 等。