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Results of pancreatic blood shunting into the systemic blood flow in insulin-dependent diabetics.
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MedLine Citation:
PMID:  8809578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A new surgical method of treating patients with unstable insulin-dependent diabetes (IDD) has been developed--that of surgically shunting pancreatic blood into the systemic blood flow with the purpose of creating a more optimal interaction of subcutaneously administered insulin and pancreas-secreted glucagon. The long term results of the operation depend on the patency of a splenorenal anastomosis. This has been studied by following up 137 patients over periods from half a year to three years. Anastomotic patency was determined by renal and splenic venography and celiacy arteriography, which revealed a patent anastomosis in 114 patients, and an obliterated one in 23. Patients with patent anastomoses showed a lowering of glycosylated hemoglobin (HbA1c) from 13.3 +/- 0.3% to 9.3 +/- 0.6%, p < 0.05, a decrease of the injected insulin dose from 0.97 +/- 0.04 to 0.72 +/- 0.03 U/kg, p < 0.05, disappearance or considerable abatement of pain in the lower extremities, and of hypoglycemia. Improvement of clinical status was accompanied by an increase of glucagon in the systemic blood stream from 60.8 +/- 10.1 to 91.5 +/- 9.4 pg/ml, p < 0.05, a rise of tissue oxygen pressure, pO2, from 49.2 +/- 2.4 to 58.1 +/- 1.9 mm Hg, p < 0.05. In patients with oblivious anastomoses postoperative HbA1c levels did not change from preoperative values: 12.9 +/- 0.4% and 12.8 +/- 0.7%, p < 0.05, respectively; the insulin dose remained the same--0.91 +/- 0.07 U/kg and 0.85 +/- 0.07 U/kg, p < 0.05, no rise of the systemic blood glucagon content was noted, and former complaints continued. The suggested method is not an alternative for insulin therapy, but considerably enhances its potential.
Authors:
E I Galperin; T G Diuzheva; P F Petrovsky; Chevokin AYu; K V Dokuchayev; S E Rabinovich; E P Gitel; N F Kuzovlev; L V Platonova
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  HPB surgery : a world journal of hepatic, pancreatic and biliary surgery     Volume:  9     ISSN:  0894-8569     ISO Abbreviation:  HPB Surg     Publication Date:  1996  
Date Detail:
Created Date:  1996-12-05     Completed Date:  1996-12-05     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9002972     Medline TA:  HPB Surg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  191-7     Citation Subset:  IM    
Affiliation:
Department of Hepatic and Metabolic Surgery, I.M. Sechenov Medical Academy, Moscow, Russia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Glucose / analysis
Diabetes Mellitus, Type 1 / blood,  drug therapy,  radiography,  surgery*
Female
Glucagon / blood
Hemoglobin A, Glycosylated / analysis
Humans
Hydrocortisone / blood
Insulin / administration & dosage
Male
Middle Aged
Pancreas / blood supply*
Renal Veins / radiography
Splenic Vein / radiography
Splenorenal Shunt, Surgical*
Vascular Patency
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 11061-68-0/Insulin; 50-23-7/Hydrocortisone; 9007-92-5/Glucagon

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

Full Text
Journal Information
Journal ID (nlm-ta): HPB Surg
ISSN: 0894-8569
ISSN: 1607-8462
Publisher: Hindawi Publishing Corporation
Article Information
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Copyright ? 1996 Hindawi Publishing Corporation.
open-access: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received Day: 24 Month: 2 Year: 1994
Print publication date: Year: 1996
Volume: 9 Issue: 4
First Page: 191 Last Page: 197
ID: 2443778
PubMed Id: 8809578
Publisher Item Identifier: S089485699641904X
DOI: 10.1155/1996/41904

Results of Pancreatic Blood Shunting into the Systemic Blood Flow in Insulin-Dependent Diabetics
E. I. Galperin2
T. G. Diuzheva1
P. F. Petrovsky1
A. Yu. Chevokin1
K. V. Dokuchayev1
S. E. Rabinovich1
E. P. Gitel1
N. F. Kuzovlev1
L. V. Platonov1
1Department of Hepatic and Metabolic SurgeryI.M. Sechenov Medical AcademyMoscowRussia
239 Bolshaya Gruzinskays Streetap. 45Moscow123056 Russia


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