Document Detail

Effect of pancreaticojejunostomy on fibrosis, pancreatic blood flow, and interstitial pH in chronic pancreatitis: a feline model.
MedLine Citation:
PMID:  10561091     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the relation between fibrosis, pancreatic blood flow (PMBF), interstitial pH (pHi), and the effects of pancreaticojejunostomy (PJ) in chronic pancreatitis.
BACKGROUND: Chronic pancreatitis is associated with low PMBF and pHi, suggesting the existence of underlying ischemia.
METHODS: In cats, the main pancreatic duct was partially obstructed and the animals were studied 2, 4, 6, and 8 weeks later. PJ was performed after 2 and 4 weeks of ductal obstruction and studied 4 weeks later. PMBF and pH were measured before and after stimulation with secretin and cholecystokinin. pHi was measured with microelectrodes, PMBF by hydrogen gas clearance. Histologic analysis of the pancreas with Sirius red (collagen stain) and fast green FCF (noncollagen protein) stains allowed semiquantitative analysis of the ratio between collagen and total protein (C/TP).
RESULTS: With the evolution of chronic pancreatitis, there is a progressive increase in the collagen content and C/TP ratio, a reduction in basal PMBF and pHi, and loss of the normal response to stimulation. Early PJ restores collagen content, C/TP ratio, and basal and stimulated PMBF and pHi to normal. PJ performed in established CP returns the C/TP ratio to normal, improves basal PMBF, and restores the normal hyperemic response to secretion. Basal pHi is improved and the "acid tide" associated with secretin returns, but there is still no response to cholecystokinin.
CONCLUSIONS: Pancreaticojejunostomy restores the elevated collagen and C/TP ratio to normal and reverses the ischemia present in CP. The authors speculate that restoration of PMBF and its normal response to stimulation allows "regeneration" and restoration of secretory function.
A G Patel; P U Reber; M T Toyama; S W Ashley; H A Reber
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  230     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-16     Completed Date:  1999-12-16     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  672-9     Citation Subset:  AIM; IM    
Department of Surgery, Sepulveda VA Medical Center, Los Angeles, California, USA.
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MeSH Terms
Chronic Disease
Disease Progression
Hydrogen-Ion Concentration
Pancreas / blood supply*,  pathology*
Pancreatitis / metabolism*,  physiopathology*
Regional Blood Flow
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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