Morpholigical and Functional Changes of Remnant Pancreas after Pancreatoduodenectomy.

Abstract

Introduction: Atrophy of the pancreatic parenchyma, which occurs frequently after pancreatoduodenectomy (PD), is often associated with functional changes. The aim of this study was to evaluate about morphological and functional changes of the remained pancreas and to determine risk factors for these changes after PD Method: 48 patients who underwent pancreatoduodenectomy at Kyungpook National University Medical Center were enrolled into this study. Clinicopathological findings were collected 48 patients who underwent pancreatoduodenectomy were enrolled into this study. Clinicopathological findings were collected retrospectively. Result: The remnant pancreatic volume decreased by average 49.3% and the decline of volume reduction was the largest within 3 months after PD. Eleven patients (34.4%) developed ductal dilatation after surgery. Diabetes mellitus was newly present in 13 of 48 (27.1%) patients. The volume reduction of the remnant pancreas in malignant disease was larger although there was no statistical difference (p = 0.058). Postoperative pancreatic atrophy was associated with origin of disease (p = 0.003). Atrophic change was prominent in ampullary and bile duct tumor. A significant atrophy was frequently observed in patients who were occurred pancreatitis (P = 0.042). The amount of pancreatic atrophy was larger in the patients who were occurred pancreatic fistula than that of others but no significant difference was found (p = 0.308) Conclusion: The loss of pancreatic parenchyma did not correlated with postoperative diabetes. The morphological change was mainly happened in short term postoperative period. Early operative complications such as pancreatitis and pancreatic fistula seem to be associated with atrophic change of the pancreatic remnant. Therefore, perioperative consideration for reducing pancreatic inflammation should include