【博士論文】学術データベース

博士論文 / Long-term outcomes after pancreaticoduodenectomy using pair-watch suturing technique: Different roles of pancreatic duct dilatation and remnant pancreatic volume for the development of pancreatic endocrine and exocrine dysfunction

著者

書誌事項

タイトル

Long-term outcomes after pancreaticoduodenectomy using pair-watch suturing technique: Different roles of pancreatic duct dilatation and remnant pancreatic volume for the development of pancreatic endocrine and exocrine dysfunction

著者名

飯澤祐介

著者名

Iizawa Yusuke

学位授与大学

三重大学 (大学ID:0046) (CAT機関ID:KI000538)

取得学位

博士(医学)

学位授与番号

乙医学第1010号

学位授与年月日

2017-12-20

注記・抄録

Background: We evaluated long-term outcomes including endo- and exocrine functions after pancreaticoduodenectomy (PD) with standardized ancreaticojejunostomy, paying attention to postoperative pancreatic duct dilatation (PDD) and remnant pancreatic volume (RPV), and examined whether postoperative pancreatic fistula (POPF) influenced the configuration of remnant pancreas. Methods: We analyzed the records of 187 patients with PD who could have RPV measured by CT volumetry at 1 month after operation and had been followed for more than 6 months. We assessed the risk factors of diabetes mellitus (DM) and PDD, and evaluated association between RPV and pancreatic endo- and exocrine functions assessed by several markers such as albumin, cholesterol, amylase and HbA1c. Results: Regarding RPV, pancreatic exocrine functions were significantly impaired in the small-volume group (SVG: less than 10 ml) than in the large-volume group (LVG: 10 ml or more). The incidence of new-onset or exacerbation of DM did not differ between SVG and LVG. PDD and the primary disease (pancreatic ductal adenocarcinoma compared to bile duct cancer) were selected as the independent risk factors of new-onset or exacerbation of DM by multivariate analysis. Unexpectedly, there was no significant association between POPF and PDD. Conclusions: Early occurrence of POPF after PD did not influence the development of PDD in late period, and long-term follow-up should be made by paying attention to PDD and RPV, because PDD was recognized as the most important risk factor of new-onset or exacerbation of DM and the patients with small RPV suffered from prolonged exocrine dysfunction rather than endocrine dysfunction.

本文 / Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine

8p

内容の要旨・審査結果の要旨 / 三重大学大学院医学系研究科 生命医科学専攻 病態修復医学講座 肝胆膵・移植外科学分野

キーワード

albumin, Diabetes mellitus, Cholesterol, amylase, Pancreatic configuration

各種コード

NII論文ID(NAID)

500001054994

NII著者ID(NRID)
  • 8000001172703
  • 8000001172704
DOI (出版社)

10.1016/j.pan.2017.06.008

本文言語コード

eng

データ提供元

機関リポジトリ / NDLデジタルコレクション

博士論文 / 三重大学 / 医学

博士論文 / 三重大学

博士論文 / 医学

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