Histological Loss of Pancreatic Exocrine Cells Correlates With Pancreatic Exocrine Function After Pancreatic Surgery

Abstract

Pancreatoduodenectomy induced pancreatic exocrine insufficiency more frequently than DP. Histological loss of acinar cells in the pancreatic stump was strongly correlated with postoperative pancreatic exocrine function.

Pancreatic exocrine insufficiency in pancreatic cancer: A review of the literature

“…The higher postoperative PEI prevalence following pancreatic head resection versus DP was also delineated by Yuasa et al in 110 patients who underwent PD (n = 10), PPPD (n = 70), and DP (n = 30) for intraductal papillary mucinous neoplasm (IPMN, n = 30), pancreatic cancer (n = 26), ampullary cancer (n = 15), and cholangiocarcinoma (n = 10) [41]. Based on 13 C-labelled mixed triglyceride breath test at 17 months (median) postoperative, 64% of patients had PEI in the pancreatic head resection cohort (PD and PPPD) and 30% in the DP cohort (n = 30) [41].…”

“…Multiple authors used the pancreatic main duct diameter, the pancreatic glandular diameter, and the degree of pancreatic fibrosis as predictors for postoperative PEI [41]. Focusing on the main pancreatic duct diameter, Sato et al reported in 44 patients, including 11 with pancreatic cancer, that a preoperative duct diameter ≥10 mm was associated with a lower postoperative PABA excretion at 2 months in comparison with normal preoperative duct diameter (53% versus 89%) [27].…”

Paradoxical impact of the remnant pancreatic volume and infectious complications on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy

“…Yuasa et al. examined the exact pancreatic function using 13C‐labeled mixed triglyceride breath test after pancreatectomy, revealing that the rate of pancreatic exocrine insufficiency in patients undergoing PD is significantly higher than that in patients undergoing DP: 64% vs. 30% ( P = 0.002). Furthermore, DP is not associated with gastrointestinal reconstruction such as pancreaticojejunosotmy and hepaticojejunosotmy, which may promote the increased risk of gut‐derived endotoxin and cytokine production.…”

Pancreatic Exocrine Insufficiency in Pancreatic Cancer

“…Japanese authors have reported a high incidence of PEI diagnosed using the 13C-MTG-BT [38,39,40]. Most of the studies performed so far have shown clearly that the incidence of PEI after PD for pancreatic tumors is high, with a range of 64%–100%.…”