- 作者：Hiroyuki Nakamura M.D. ; ; ; hsurgeon1017@aioros.ocn.ne.jp ; Yoshiaki Murakami M.D. ; Kenichiro Uemura M.D. ; Yasuo Hayashidani M.D. ; Takeshi Sudo M.D. ; Hiroki Ohge M.D. ; Taijiro Sueda M.D.
- 关键词：pylorus-preserving pancreatoduodenectomy ; postoperative exocrine pancreatic function ; 13C-labeled mixed triglyceride breath test ; pancreatic parenchymal thickness
- 刊名：Journal of Surgical Research
- 出版年：2011
- 出版时间：December 2011
- 年：2011
- 卷：171
- 期：2
- 页码：473-478
- 全文大小：280 K
Background
The aim of this study was to investigate whether perioperative morphologic characteristics are predictive of exocrine pancreatic function after pylorus-preserving pancreatoduodenectomy (PPPD) with pancreaticogastrostomy.Materials and Methods
A 13C-labeled mixed triglyceride breath test was performed in 52 patients after PPPD to assess postoperative exocrine pancreatic function. A value of percent 13CO2 cumulative dose at 7 h ( % CD-7h) of less than 5 % was considered diagnostic of exocrine pancreatic insufficiency. Pre- and postoperative pancreatic parenchymal thicknesses were calculated using computed tomography (CT) scans, and compared by means of receiver operating characteristic (ROC) analysis.
Results
Thirty-four (65.4 % ) of 52 patients were found to have exocrine pancreatic insufficiency based on the breath test. With ROC analysis for identification of exocrine pancreatic insufficiency, the areas under the ROC curve for the postoperative pancreatic parenchymal thickness were higher than those for the preoperative pancreatic parenchymal thickness (0.904 and 0.702, respectively, P = 0.009). When the cut-off value of the postoperative pancreatic parenchymal thickness was set at 13.0 mm, the sensitivity and specificity for identifying exocrine pancreatic insufficiency were 88.2 % and 88.9 % , respectively.
Conclusion
Reduced postoperative pancreatic parenchymal thickness is a reliable indicator of exocrine pancreatic insufficiency after PPPD.