The study about atropy of remnant pancreas after pancreaticoduodenectomy / 한국간담췌외과학회지

ABSTRACT

BACKGROUND: The pacreaticoduodenectomy is the procedure of choice for neoplasm of periampullary region. However, some complications such as glucose intolerance and maldigestion are developed on postoperative long-term follow-up. The aim of this study is to evaluate the volume change of remnant pancreas and difference of thickness change between PPPD and Whipples'operation. Material and METHODS: From November, 1988 to June, 1998, 110 patients with periampullary neoplasms had undergone pancreaticoduodenectomy in our hospital(Whipple procedure 67, pylorus-preserving pancreaticoduodenectomy 43). We selected 19 patients who had regular interval follow-up during at least 1 year and didn't have operation related complications and recurrence(Whipple procedure 8, PPPD 11). We examined the size of body and tail of pancreas on preoperative CT and postoperative CT. Medical records were reviewed to find body weight changes, occurrence of glucose intolerance and steatorrhea. RESULTS: The size of body and tail of pancreas were 16.2+/-3.9mm and 12.1+/-5.0mm preoperatively, 10.8+/-3.9mm and 8.3+/-3.5mm postoperatively(p<0.001). However, there was no significant difference between Whipple and PPPD group. The body weight reduced to 95% of preoperative body weight, but it didn't show statistic sigificance. The occurrence of glucose intolerance and steatorrhea were insignificant. CONCLUSION: We conclude that pancreatic atrophy develop in patients underwent pancreticoduodenectomy. But, the difference of thickness change between PPPD and Whipples'group is no significance. We suggest that further study is need to find out the cause of pancreatic atrophy and correlation between atrophy and resection method such as duodenum preserving pancreatic head resection versus pancreaticoduodenectomy. Also we recommend that long-term follow-up study is necessary to find out correlation between pancreatic atrophy and pancreatic endocrine, exocrine insufficiency.