A new evaluation of pancreatic function after pancreatoduodenectomy using secretin magnetic resonance cholangiopancreatography

Sho, Masayuki; Nakajima, Yoshiyuki; Kanehiro, Hiromichi; Hisanaga, Michiyoshi; Nishio, Kazushi; Nagao, Mitsuo; Tatekawa, Yukihiro; Ikeda, Naoya; Kanokogi, Hideki; Yamada, Takatsugu; Hirohashi, Shinji; Hirohashi, Rina; Uchida, Hideo; Nakano, Hiroshige

« Previous Next »The American Journal of Surgery
Volume 176, Issue 3 , Pages 279-282, September 1998

A new evaluation of pancreatic function after pancreatoduodenectomy using secretin magnetic resonance cholangiopancreatography

Masayuki Sho, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
- Requests for reprints should be addressed to Masayuki Sho, MD, First Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634, Japan
Yoshiyuki Nakajima, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Hiromichi Kanehiro, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Michiyoshi Hisanaga, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Kazushi Nishio, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Mitsuo Nagao, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Yukihiro Tatekawa, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Naoya Ikeda, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Hideki Kanokogi, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Takatsugu Yamada, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Shinji Hirohashi, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Rina Hirohashi, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Hideo Uchida, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
Hiroshige Nakano, MD
- First Department of Surgery and the Department of Radiology, Nara Medical University, Kashihara, Nara, Japan

Received 7 January 1998; received in revised form 13 May 1998; accepted 13 May 1998.

Abstract

Background: The remnant pancreatic function after pancreatoduodenectomy influences greatly postoperative quality of life. However, it has been difficult to evaluate the exocrine remnant pancreatic function postoperatively. The aim of this study was to assess the usefulness of secretin-stimulated magnetic resonance cholangiopancreatography (secretin MRCP) in evaluating the remnant pancreatic function and ascertaining the anastomotic patency after pancreatoduodenectomy.

Methods: Thirty-four patients who underwent pancreatoduodenectomy were evaluated with secretin MRCP. The results of MRCP were determined by the amount of exocrine pancreatic secretion, and were graded as follows: grade I (poor secretion), grade II (moderate secretion), and grade III (good secretion).

Results: Secretin MRCP could visualize the pancreatic secretion dynamically. MRCP grades were grade I in 11 patients, grade II in 12, and grade III in 11. There was a significant correlation between MRCP grade and glucose tolerance. We confirmed visually the patency of the anastomotic site in 24 patients (71%). MRCP grades correlated significantly with clinical symptoms.

Conclusion: Our results demonstrated secretin MRCP was feasible for evaluating the remnant pancreatic function after pancreatoduodenectomy.