J.Jpn. Surg. Soc.. 87(1): 111-117, 1986
Case report
A CLINICAL REPORT OF VASCULARIZED SEGMENTAL PANCREATIC AUTOTRANSPLANTATION FOR CHRONIC PANCREATITIS
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First Department of Surgery, Shimane Medical University, Izumo, Japan Katsuhiro Tamura, Seikon Kin, Keiji Ono, Takao Tarumi, Masahisa Nakagawa, Akira Nakase |
Distal 80％ of the gland with severe calcified pancreatitic change was resected and prepared for transplantation by injecting the splenic artery with Ringer’s lactate solution containing heparin, albumin and gabexate mecilate cooled to 4℃. The spleen was removed from the specimen. An arteriovenous fistula was constructed at the tail. End-to-side anastomosis of spleno-external iliac veins was carried out after small fusiform resection of the iliac venous wall for the purpose of sufficient venous patency. End to-end anastomosis of spleno-hypogastric arteries was done. The pancreatic stump was anastomosed to the ileum.
Post-operatively, the pain completely resolved. Patency of the graft was demonstrated by angiography. Higher response of the C-peptide immunoreactivity on 75gOGTT was found in the iliac veill on the transplanted side than in another peripheral vein. The exocrine pancreatic function diagnostant test showed 78.8％ post-operatively (vs. 63.2％ pre-operatively).
Vascularized segmental pancreatic autotransplantation offers an excellent method of relieving pain with preservation of endocrine and exocrine functions in selected cases with chronic pancreatitis.
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