Relationship Between Grade of Fibrosis in Pancreatic Stump and Postoperative Pancreatic Exocrine Activity After Pancreaticoduodenectomy: With Special Reference to Insufficiency of Pancreaticointestinal Anastomosis.

Abstract

The degree of fibrosis in the pancreatic stump is significantly related to the EAPR and affects the development of PIA insufficiency as a local factor.

Assessment of Pancreatic Hardness—Surgeon versus Durometer

“…The grade of pancreatic fibrosis has also been reported recently to correlate with the risk of pancreatic leakage after pancreatic resections [31,32]. As fibrotic tissue is suggested to be harder than nonfibrotic tissue, we hypothesized that the grade of pancreatic fibrosis may be a good histological correlation of pancreatic hardness.…”

Smoking Is Related to Pancreatic Fibrosis in Humans

“…Th e relationship between smoking and the development of PF is a major element in CP, PC (25 -27 ), postoperative pancreatic anastomotic leakage (28,29), and pancreatic exocrine insuffi ciency aft er a Whipple procedure ( 29,30 ). Two observational studies reported a signifi cant relationship between cigarette smoking and pancreatic exocrine insuffi ciency ( 31,32 ).…”

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

“…Tran et al 15 analyzed 74 patients with periampullary carcinoma and chronic pancreatitis who underwent PD to investigate a correlation between the extent of pancreatic fibrosis and postoperative pancreatic exocrine function, using fecal elastase-1 test: They concluded that the extent of pancreatic exocrine insufficiency is strongly correlated with preoperative fibrosis. In addition, Uchida et al 31 reported that the degree of fibrosis in the pancreatic stump is significantly related to the exocrine activity of the pancreatic remnant with an analysis of 28 patients with periampullary carcinoma who underwent PD. However, there have been no reports concerning relationship between postoperative pancreatic exocrine function and histological changes of pancreatic parenchyma, which was analyzed by 13 C-labeled mixed triglyceride breath test.…”