Pancreatic ductal and interstitial pressures in cats with chronic pancreatitis

Abstract

We investigated the etiology of interstitial hypertension in chronic pancreatitis by examining the relationship between pancreatic ductal and interstitial pressures in cats. The main pancreatic duct was cannulated in the tail of the gland and perfused at 1, 2, or 5 ml/hr, to simulate pancreatic secretion. Intraductal and interstitial pressures were measured in four groups of animals: (1) normal cats; (2) normal cats after acutely narrowing the main duct to 25% of its original diameter; (3) normal cats after encasing the body and tail in a rigid latex capsule; and (4) cats with chronic pancreatitis created by narrowing the main duct five weeks earlier. Duct perfusion increased intraductal pressure in all of the cats, but significantly more in groups 2, 3, and 4 compared to group 1. Pancreatic interstitial pressure was unchanged by duct perfusion in groups 1 and 2, but increased in groups 3 and 4. We concluded that the compliant tissue of the normal pancreas expanded to effectively dissipate the increase in duct pressure associated with duct perfusion. In chronic pancreatitis, the inelastic parenchyma and capsule limited the distensibility of the gland, which resulted in elevated interstitial pressures during duct perfusion.

Pressure activates rat pancreatic stellate cells

“…These events can be also observed in the animal model of chronic pancreatitis (23,39). In this model, the restrictive fibrotic capsule enveloping the gland prevents dissipation of the main pancreatic duct pressure.…”

“…It is well known that pancreatic tissue pressure in chronic pancreatitis is higher than that in normal pancreas (20,32). In the animal model of chronic pancreatitis, the parenchymal fibrosis and restrictive fibrotic capsule enveloping the gland prevents dissipation of the main pancreatic duct pressure (23). This could account for the increase of tissue pressure in chronic pancreatitis.…”

Endoskopische Therapieansätze bei chronischer Pankreatitis

“…Dieses Modell, dass prinzipiell im Tiermodell [14] wie auch intraoperativ an Menschen [15,16] nachvollzogen werden konnte, stellt die theoretische Grundlage für viele interventionelle Maßnahmen dar. Als Voraussetzung für die endoskopische Intervention bei Pankreasgangstenosen ist die endoskopische Papillotomie des Pankreasgangs (PG-EST) akzeptiert [17].…”

Endoscopic sphincterotomy in patients with stenosis of ampulla of Vater: Three-year follow-up of exocrine pancreatic function and clinical symptoms

“…This might also play a role in the pathogenesis of chronic pancreatitis. Segmental or diffuse dilation of the main pancreatic duct as part of the spectrum of chronic pancreatitis has given rise to the concept of obstruction and pancreatic ductal hypertension as an important pathogenetic mechanism of chronic pancreatitis [8,9] . Data from an autopsy study also showed that the incidence of chronic pancreatitis is higher in patients with gallstones which emphasises the role of gallstones, sludge and papillary stenosis in the pathogenesis of chronic pancreatitis [10] .…”