SEARCH · PubMed Health

Results for “PANCREATECTOMY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources

PubMed1991

[A case of unstable diabetes mellitus after total pancreatectomy controlled by CSII].

Continuous subcutaneous insulin injection (CSII) is one of good methods to control unstable diabetes. In this paper, we reported a case of a patient with unstable diabetes after total pancreatectomy, to whom CSII was very effective. The case was 53 years of age, lean woman. In 1980, she had pancreatoduodenectomy for the treatment of cancer of duodenal papilla. In June, 1986, she was diagnosed as recurrence of the cancer, and undertaken total pancreatectomy. And then, insulin treatment was commended. But she readily developed hypoglycemic reactions by ordinary insulin injection once or twice a day, and glycemic control was very poor. On April 22, 1987, CSII was started. 8 units of regular insulin were given during 24 hours, and 2 units of regular insulin were added before every meal. Thereafter, the frequency of hypoglycemic reaction decreased dramatically, and HbA1c level decreased from 8.5% to 8.1% three months later. This report indicated usefulness of CSII to patients with unstable diabetes, who couldn't be controlled by ordinary insulin injection.

Aged↗

PubMed1991

CT of liver steatosis after subtotal pancreatectomy.

The liver attenuation of 50 patients operated with a subtotal pancreatectomy for pancreatic and duodenal tumors was evaluated with CT. Of 18 patients surviving more than 18 months after surgery, 7 developed a markedly reduced liver attenuation indicating liver steatosis. No patient became diabetic or showed evidence of malnutrition after surgery. No correlation between the liver attenuation values and the patients' liver function tests was noted. The steatosis was reversible in 4 of the 7 patients. The pathophysiological cause of the steatosis remains unknown. Partial pancreatectomy should be included among the reasons listed for liver steatosis.

Aged↗

PubMed1989

Insulin antibodies and management of diabetes after total pancreatectomy.

For 18 patients after total pancreatectomy, serial determinations of plasma immunoreactive insulin bound with insulin antibody (binding IRI) were performed to ascertain the relationship between insulin antibody formation and diabetic stability. As a result, seven patients treated with human DNA insulin experienced neither unstable diabetic control (UDC) nor binding IRI elevation. On the other hand, six (58%) of 11 patients treated with beef and porcine insulins began to experience UDC with elevation of binding IRI. For these six patients, the binding IRI level was as low as 242 +/- 100 microU/ml at the onset of UDC and continued to increase (maximum binding IRI, 2048 +/- 1707 microU/ml) without spontaneous recovery from UDC. However, three patients recovered from UDC by the transfer to human DNA insulin, with a small decrease in binding IRI (470 to 4400 microU/ml) at the end of UDC. An equilibrium binding assay and the kinetic analysis of insulin antibodies showed that high-affinity antibody capacity (Ab1) for beef insulin was 28 +/- 6 ng/ml immediately before UDC, 306 +/- 120 ng/ml (115 to 578 ng/ml) during UDC, and 28 +/- 12 ng/ml immediately after UDC. Low-affinity antibody capacity was not correlated with diabetic stability. Therefore, in the totally pancreatectomized patients, it was concluded (1) that Ab1 was associated with the UDC onset or the recovery and (2) that UDC developed with far lower levels of Ab1, in contrast with patients with insulin-dependent diabetes. This is a reason why serial determination of insulin antibody, especially Ab1, is necessary for control of diabetes after total pancreatectomy.

Adult↗

PubMed1989

[Therapeutic problems of patients with diabetes mellitus after total pancreatectomy].

Followed were 11 patients after total pancreatectomy (for carcinoma--6 patients, for sequelae of the chronic pancreatitis--5 patients), aged 52-62 years. The follow-up period ranged 5 months up to 4 years. All pacreatomized patients had diabetes needing insulin administration, although the need for insulin decreased with time down to 16-40 units/24 hours after one year. The diabetes was rather brittle with high incidence of hypoglycaemia. In 7 patients keeping exact records the incidence of hypoglycaemic events was 16-24 within the first month, 9-16 in the third month following pancreatectomy. In two patients death was due to the severe hypoglycaemia developing in the later postoperative period. The observations call for a necessary "intensive metabolic care" of every patient, totally pancreatomised. This intensive metabolic care must include not only careful instructing the patients but also his or her family how to behave in a totally different metabolic condition of the patient. Self-control, including blood sugar estimation several times a day gets special importance.

Blood Glucose Self-Monitoring↗

PubMed1989

Technical considerations in distal pancreatectomy with splenic preservation.

Splenic preservation may be attempted when distal pancreatectomy is performed for nonmalignant disease. The splenic artery and vein can be preserved with meticulous control of the multiple small, thin-walled branches that tether these vessels to the pancreas, allowing splenic salvage. Mobilization of the spleen into the operative field, ligation of the short gastric vessels and splenectomy are not performed. Thus, the operative procedure may be accomplished in carefully selected patients with little increase in operative time or blood loss over conventional distal pancreatectomy with splenectomy.

Humans↗

PubMed1989

[Distal pancreatectomy with conservation of the spleen. Apropos of 3 consecutive cases].

Three distal pancreatectomies with preservation of the spleen are described. The indications were infiltration of the pancreatic tail by a gastric adenocarcinoma in the first patient; acute and chronic inflammation of the pancreas in the second and third. This type of operation takes very little longer than classic distal pancreatectomy with splenectomy, does not increase the incidence of postoperative complications and above all prevents the onset of sometimes lethal sepsis especially in young patients.

Acute Disease↗

PubMed1989

Technetium-99m sulfur colloid spleen imaging following partial pancreatectomy and splenic artery and vein resection.

We retrospectively studied the records and [99mTc]sulfur colloid (TSC) spleen studies of 38 patients who underwent distal pancreatectomy with splenic artery and vein resection for donation to HLA-compatible relatives. The spleens in immediate postoperative TSC studies were normal in 11% of cases, showed no uptake in 16%, showed diffusely decreased uptake in 50%, and showed focal defects in 26%. Twenty of the patients, all with abnormal initial TSC studies, had repeat studies 2 wk to 3 yr later; 15% showed no change, 35% showed some improvement, and 45% became normal. One of six patients with no TSC uptake required splenectomy 2 days after pancreatectomy for splenic infarction. These data suggest that the spleen usually survives splenic artery and vein resection. Absent splenic TSC uptake raises the possibility of splenic infarction.

Adult↗

PubMed1989

[Splenic salvage in distal pancreatectomy].

In distal pancreatectomy, splenectomy has usually been an expedient component. In view of the recognized risk of overwhelming postsplenectomy septicaemia the current trend is splenic salvage whenever possible, in trauma surgery as well as in elective surgery. In order to emphasise this point we report a case of distal pancreatectomy with splenic salvage.

Female↗

PubMed1988

[Pathophysiology during follow-up after extensive pancreatectomy].

In 20 cases of total pancreatectomy and 74 cases of pancreaticoduodenectomy, pancreatic endocrine and exocrine functions in long-term survival after surgery were investigated, particularly in relation to development of fatty liver, metabolic bone disorder and changes of serum zinc. In cases of pancreaticoduodenectomy, although the residual pancreatic endocrine and exocrine functions decreased in 1 or 2 months, they were recovered within a year and these functions were maintained relatively well, but in cases of resection of fibrotic pancreas, they decreased gradually in more than 3 years after surgery. In a long-term survival, fatty liver, metabolic bone disorder and an impaired absorption of zinc developed, and such changes occurred remarkably in cases of resection of fibrotic pancreas or in cases of total pancreatectomy. Hence, after major resection of the pancreas, a long-term sufficient control should be necessary understanding these pathophysiology.

Bone Diseases, Metabolic↗

PubMed1986

Celiac artery aneurysmectomy with pancreatectomy.

A case of symptomatic celiac artery aneurysm with pancreatic involvement treated by excision, 85% pancreatectomy, and direct reanastomosis of the common hepatic artery with restoration of arterial continuity is reported. This is the first reported case, of which we are aware, in which celiac artery aneurysm resection also required partial pancreatectomy. Pancreatic involvement by celiac artery aneurysm is discussed. The rationale for early diagnosis and recommended treatment is presented.

Aneurysm↗

PubMed1985

[Experimental diabetes mellitus induced by total pancreatectomy with preservation of the duodenum in dogs].

The total pancreatectomy without duodenectomy was carried out in 16 dogs. The postoperative diabetes mellitus leads to death on average until the 11th postoperative day. A prolongation of the survival time was possible only by an insulin injection or by pancreas transplantation. Bleedings and circulatory disturbances of the duodenum occurred in 3 of 16 dogs as a complication of the operation. The diabetes mellitus was confirmed by the estimation of the fasting blood glucose and the glucose stimulated plasma insulin concentration. The irreversible hyperglycemia syndrome after pancreatectomy proved as a pattern for the pancreas segmental transplantation.

Animals↗

PubMed1966

Partial and total pancreatectomy for periampullary carcinoma.

Total pancreatectomy for periampullary carcinoma should be reserved for resectable primary carcinoma in the pancreas. The postoperative complications are reduced, and the resultant diabetes is not difficult to manage. There were no postoperative deaths in series of 12 cases of total and partial pancreatectomy. This study proposes a more aggressive approach to malignant lesions in this area.

Aged↗

PubMed1984

Near-total pancreatectomy for chronic pancreatitis.

Eighty-seven patients underwent distal subtotal or near-total (80% to 95%) pancreatectomy (NTP) during a 25-year period for management of intractable pain resulting from chronic pancreatitis. Alcoholism affected the majority of patients and 20% of cases were idiopathic in origin. Ten patients (12%) exhibited insulin-requiring diabetes before operation. The perioperative mortality rate was 3.4%. Significant improvement or complete pain relief was achieved in 75% of patients while 14% remained narcotic dependent. Forty-four patients (51%) required insulin postoperatively, with an average insulin requirement of 35 U per day. Thirty late deaths occurred 2 to 15 years after operation, 12 (40%) of which were related to complications of pancreatic insufficiency or persistent alcoholism. Five patients (8.5%) required completion pancreatectomy 6 months to 4 years after NTP for complications relating to persistent pancreatitis. NTP provides effective pain relief in the majority of patients with chronic pancreatitis. While this procedure can be performed with a low operative mortality rate, the high incidence of endocrine and exocrine insufficiency after operation may contribute to late deaths. Consequently, this procedure should be performed only when the underlying disease has functionally destroyed the pancreas or when lesser procedures have failed to provide adequate pain relief.

Adolescent↗

PubMed1983

[Congenital nesidioblastosis. Successful treatment with total pancreatectomy].

A 6,410 g newborn baby suffered from severe hypoglycemia despite therapy with high doses of diazoxide and glucagon as well as intravenous application of glucose. There was no persistent response of blood glucose to continuous infusion of somatostatin. A 85% pancreatectomy was performed at the age of 6 weeks, after biochemical findings had indicated hyperinsulinism. As the hypoglycemia reappeared postoperatively, the child underwent total pancreatectomy. Now, at the age of 9 months, the baby's growth and development is normal under substitution therapy with Pankreon and depot-insulin 0.2 U/kg/day.

Diabetes Mellitus, Type 1↗

PubMed1982

Effects of total pancreatectomy and amino-acid treatment on plasma amino-acids and glucose in the goose.

1. Total pancreatectomy in the goose, in addition to the effects previously described (fatal hypoglycaemia and impaired tolerance), increases markedly the plasma amino-acid level. This increase corresponds to a significant rise in individually tested plasma amino-acids. In addition, pancreatectomy suppresses the hyperglycaemia which normally follows arginine treatment. 2. Oral administration of arginine induces hyperglycaemia in normal, but not in depancreatized geese. Therefore, the arginine effect upon the blood glucose level could be mediated by glucagon. Plasma glucose and glucagon changes, in normal animals with oral administration or i.v. infusion (Khemiss and Sitbon, 1982), agree with this conclusion. 3. Conversely, alanine elicits hyperglycaemia in normal animals, and such hyperglycaemia persists in pancreatectomized geese. Therefore, in the goose, in contrast to the duck, alanine appears to be a strong gluconeogenic amino-acid. These experiments with alanine indicate that closely related species, such as ducks and geese, may present important physiological differences.

Administration, Oral↗

PubMed1994

[Studies on leakage of pancreatic juice following distal pancreatectomy from the standpoint of transition of amylase and trypsin values in exudate].

Selective drainage method of remnant pancreatic stump (RPS) using latex rubber was devised, and I have obtained a good clinical result for the prevention of postoperative bleeding due to the leakage of pancreatic juice after distal pancreatectomy. In this study, amylase (Am:IU/L) and trypsin (Tr:ng/ml) values in exudate were measured to clarify the actual leakage of pancreatic juice. Thirty-three patients with gastric cancer who underwent total gastrectomy with distal pancreatectomy were chosen for this study; 21 cases of selective drainage (group A) and 12 cases of non-selective drainage (group B). The results are noted below. 1) Both Am and Tr values of group A in the exudate from remnant pancreatic stump were statistically higher than those of group B (p < 0.01). Mean values of group A and group B on the first post-operative day were 25.6 x 10(4) versus 2.6 x 10(4)IU/L (Am value) and 324.4 x 10(4) versus 12.2 x 10(4)ng/ml (Tr value), respectively. 2) The mean values rapidly decreased and bottomed on the sixth postoperative day. 3) Not only total drainage amount of Am (sigma Am: sum of Am value x exudate volume from each drain) but also sigma Tr in group B were markedly less than in group A (p < 0.01). It means that more than 40% of pancreatic juice remained in the abdomen without drainage in group B. In conclusion, effective and active drainage of remnant pancreatic stump for the initial three days at least is important to prevent complications and our selective drainage is one of the excellent methods.

Amylases↗

PubMed1993

[Pancreatic regeneration after major pancreatectomy and effect of insulin administration in dogs].

Regeneration of the remnant pancreas after more than 92% pancreatectomy with or without insulin treatment was studied in dogs. All dogs developed diabetes mellitus (DM) immediately after surgery. For the dogs in insulin-treated group, porcine insulin (NPH) was injected subcutaneously daily to maintain the fasting blood sugar levels from 70 to 130 mg/dl. All dogs without insulin treatment died within 7 weeks after surgery, whereas 87.5% of the dogs receiving insulin treatment survived until 12 weeks, and 57.1% of surviving dogs were free of DM. DNA and RNA synthesis and ornithine decarboxylase (ODC) activity in the remnant pancreatic tissue 3 days after surgery were significantly greater in the insulin-treated dogs than in the untreated dogs. Endogenous insulin secretion, exocrine pancreatic function and the regeneration rate of the remnant pancreas at the 6-7th week were significantly better in the insulin-treated dogs. Furthermore, the regeneration rate at the 6-7th week was highly correlated with DNA and RNA synthesis and ODC activity in the remnant pancreas tissue 3 days after surgery. After major pancreatectomy in dogs, insulin treatment enhances the proliferation of the remnant pancreas during the early period and maintains endogenous insulin secretion for a long period, prolonging survival and promoting pancreatic regeneration.

Animals↗

PubMed1976

Neonatal pancreatic beta-cell hyperplasia: report of a case with failure of diazoxide and benefit of early subtotal pancreatectomy.

A newborn infant with pancreatic beta-cell hyperplasia had persistent hypoglycemia due to hyperinsulinism. After medical management, including the use of diazoxide and constant glucose infusions had proved ineffective, a subtotal pancreatectomy was curative. Cumulative experience seems to indicate that there should be little delay in performing a subtotal pancreatectomy when aggressive medical management cannot maintain normoglycemia in a neonate.

Diazoxide↗