Experimental and Clinical Studies on Transplantation of the Pancreas

本文报告了三年来在外科二科进行的胰腺移植的实验和临床研究。1)实验研究1)慢性胰腺炎移植的胰岛能否维持正常的血糖水平？然后将每只犬的所有胰岛细胞分别移植到每只狗的脾髓内。胰腺纤维化严重的犬胰岛移植后即刻内分泌功能紊乱，血糖维持不正常。2)节段性胰腺移植犬是否有必要引流胰管系统？11只犬在全胰腺切除后行段式胰腺移植加胰肠吻合术或胰腺囊性吻合术。所有狗在很长一段时间内内分泌功能正常，没有胰腺f-…。再来点刺绣。8只犬行段式胰腺移植加腹腔引流或用氯丁橡胶阻断胰管，但均出现进行性胰腺功能障碍，并伴有严重的纤维化。3)如何预防节段性胰腺移植犬的脾静脉血栓形成？在这些狗身上。未见鞭毛虫感染。B)临床研究：在此基础上，对4例慢性胰腺炎和5例胰腺十二指肠癌患者进行了自体胰岛移植和自体节段性胰腺移植。4例慢性胰腺炎患者行远端次全切除联合胰岛移植，3例胰腺十二指肠癌患者行全胰腺切除联合胰岛移植。1例胰腺癌患者行带脾全胰腺切除术后行自体节段性胰腺移植，1例无脾胰腺切除患者行自体节段性胰腺移植。5例患者术后功能逐渐障碍，2例患者功能与术前相比无明显变化。2例节段性自体胰腺移植中，1例因脾静脉血栓形成失活，1例术后胰腺功能正常。较少

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