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Gastrectomy reduces pancreatic secretory function via pancreatic atrophy

Authors :
Shumpei Satoi
Yutaka Kimura
Rie Shimizu
Masataka Matsumoto
Kohei Kawaguchi
Yuta Yoshida
Takaaki Murase
Keiko Kamei
Ippei Matsumoto
Takuya Nakai
Yoshifumi Takeyama
Source :
Surgery Today.
Publication Year :
2023
Publisher :
Springer Science and Business Media LLC, 2023.

Abstract

Purpose Although reports suggest that the pancreatic volume decreases after gastrectomy for gastric cancer, the relationship between the pancreatic volume and secretory function after gastrectomy remains unclear. In this study, we examined the relationship between the pancreatic volume and exocrine and endocrine functions after total gastrectomy. Methods The pancreatic volumes of 18 distal gastrectomy and 15 total gastrectomy patients were retrospectively measured using computed tomography volumetry up to 5 years postoperatively. Ten low anterior resection patients were selected as controls. In addition, the pancreatic volume and exocrine function evaluated by fecal elastase and the insulin secretory function evaluated by glucagon tolerance testing were prospectively examined before and one year after surgery in nine cases of total gastrectomy. Results After low anterior resection, the pancreatic volume did not change, but after distal and total gastrectomy, the pancreatic volume decreased continuously until the fifth year. After total gastrectomy, fecal elastase decreased significantly from 865.8 μg/g to 603.2 μg/g in the first year (p = 0.0316), and the insulin secretion capacity also decreased significantly from 3.83 ng/mL to 2.26 ng/mL (p = 0.0019). Conclusions The pancreatic volume decreases continuously after gastrectomy for gastric cancer, and the pancreatic exocrine and endocrine functions decrease along with pancreatic atrophy after total gastrectomy.

Subjects

Subjects :
Surgery
General Medicine

Details

ISSN :
14362813 and 09411291
Database :
OpenAIRE
Journal :
Surgery Today
Accession number :
edsair.doi...........87ae2959a490868fe76151c31ebfc452
Full Text :
https://doi.org/10.1007/s00595-023-02685-x