• Korean Journal of Veterinary Research
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• v.37 no.2
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• pp.245-252
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• 1997

To investigate morphological changes in the exocrine pancreas of chicken after pancreatic duct ligation, experimental animals were subdivided to control, 12 hours, 1 day, 2 days, 4 days, 7 days and 10 days groupes and all of three pancreatic ducts of chicken were ligated by surgical procedure and then the morphological changes were observed. In pancreatic ducts, once for a while the ducts were dilated on 12 hours after pancreatic duct ligation and then they were obstructed because of proliferated epithelial cells and connective tissues in pancreatic duct. Marginal dissociation of acini was detected in 12 hours after pancreatic duct ligation and then dissociation of acini was increased with time and finally in 4 days after pancreatic duct ligation the acini showed completely dissociation except periductular regions and around pancreatic islets. Most of dissociated acini cells showed marginal condensation of nuclear chromatin and atropy of cytoplasm, namely, apoptotic features were detected in dissociated acinar cells. Interacinar spaces of dissociated acinar regions were dilated and fulfilled with increased connective tissue and in 4 days after pancreatic duct ligation, deposition of lymphocytes and hemocytes was occurred.

• Korean Journal of Veterinary Research
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• v.37 no.2
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• pp.253-262
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• 1997

To investigate morphological changes in the endocrine pancreas of chicken after pancreatic duct ligation, experimental animals were subdivided to control, 12 hours, 1 day, 2 days, 4 days, 7 days and 10 days groupes and all of three pancreatic ducts of chicken were ligated by surgical procedure and then the morphological changes were observed. In pancreatic islets, the vacuolation and invasion of connective tissue were occurred in all experimental groups and dissociation of pancreatic islets was detected in 4 days after pancreatic duct ligation and hold out to 10 days. The peak of the morphological changes in pancreatic islets was detected in 4 days after pancreatic duct ligation. In the results of immunohistochemical methods against glucagon, insulin, somatostatin and bovine pancreatic polypeptide(BPP), the number of immunoreactive pancreatic islets were decreased but the size increased with time, so the number of immunoreactive cells in each pancreatic islets were increased. Glucagon-immunoreactive cells were not changed but insulin-immunoreactive cells were decreased with time(p<0.05). BPP-immunoreactive cells were increased in 2 days after pancreatic duct ligation and then decreased with time(p<0.05). Somatostatin-immunoreactive cells were increased with time(p<0.05) in dark islets.

• Journal of radiological science and technology
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• v.21 no.1
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• pp.40-45
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• 1998

To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dernier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.84-90
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• 2022

Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) remains a dreadful complication. Duct-to-mucosa pancreaticojejunostomy (DTMPJ) is a commonly performed anastomosis after PD. This study aims to evaluate whether there is a size limit of pancreatic duct below which POPF rate increases significantly after DTMPJ. Methods: A retrospective study was performed from a database with prospectively collected data on consecutive patients undergoing DTMPJ. Results: Between the years 2003 and 2019, a total of 288 patients with DTMPJ were recruited. POPF occurred in 56.3% of the patients, of which 43.8% were biochemical leak, 8.7% were grade B, and 1.4% were grade C. Overall operative morbidity was 51.4%, of which 19.1% were major complications. Five patients (1.7%) died within 90 days of operation. Patients with grade B/C POPF had significantly soft pancreas (p < 0.001), smaller duct size (p = 0.031), and a diagnosis of carcinoma of the pancreas (p = 0.027). When a clinically significant POPF rate was analysed based on the pancreatic duct diameter, pancreatic duct size ≤ 1 mm had the highest POPF rate (35.7%). There was a significant difference in POPF rate between adjacent ductal diameter ≤ 1 mm and > 1 mm to 2 mm (35.7% vs 13.3%; p = 0.040). Multivariable analysis showed that for the soft pancreas, pancreatic duct diameter ≤ 1 mm was the only significant predictive factor for POPF (p = 0.027). Conclusions: DTMPJ can be safely performed for pancreatic duct > 1 mm without significantly increased POPF risk.

• Journal of Digestive Cancer Research
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• v.3 no.1
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• pp.42-44
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• 2015

Anomalous union of the pancreaticobiliary duct (AUPBD) has been shown to predispose to carcinomas of the biliary tract (bile duct and gallbladder) and pancreatic cancer because of chronic recurrent inflammatory reaction due to pancreatic or bile juice refluxes. However, pancreatic duct would be less affected by the bile because of the relatively higher intraductal pressure of the pancreatic duct. We report a case of metachronous pancreatic cancer in AUPBD patient without choledochal cyst who underwent cholecystectomy because of gallbladder cancer.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.220-228
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• 2022

Backgrounds/Aims: In Korea, pancreatic cancer and "gallbladder and extrahepatic bile duct cancer" were ranked the 8th and 9th most frequent cancers in 2019 and the 4th and 6th most common causes of cancer deaths in 2020, respectively. Methods: This review provides national cancer statistics and secular trends of 207,521 patients with gallbladder (n = 44,178), extrahepatic bile duct (n = 61,856), and pancreatic cancer (n = 101,487) between 1999 and 2019 in Korea. Results: The crude incidence rate in both sexes increased in the gallbladder (2.8 to 5.4 per 100,000), extrahepatic bile duct (3.6 to 9.0), and pancreatic cancer (5.5 to 15.8). The age-standardized incidence rate in both sexes significantly increased in the extrahepatic bile duct (3.7 to 4.1) and pancreatic (5.6 to 7.6) cancers but decreased in gallbladder cancer (2.9 to 2.4). The overall 5-year relative survival rate increased in the gallbladder (21.8% to 30.6%), extrahepatic bile duct (23.1% to 27.5%), and pancreatic (8.5% to 13.3%) cancers. Between 2006 and 2019, the proportion of localized or regional stages remained stable. The proportion of surgical treatment within the first 4 months after diagnosis was relatively higher in the gallbladder (42.2%) and extrahepatic bile duct (45.9%) cancers than in pancreatic cancer (22.2%). Conclusions: The crude incidence and mortality rates of the gallbladder, extrahepatic bile duct, and pancreatic cancer are steadily increasing in Korea, and the prognosis remains poor. Early detection, active application of surgical treatment, and minimization of the proportion of untreated patients are required to improve the survival rates of these cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6823-6827
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• 2014

Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.

• Animal cells and systems
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• v.4 no.2
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• pp.187-193
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• 2000

Regional distribution and relative frequency of endocrine cells in the pancreas of the red-eared slider, Trachemys scripta elegans, were investigated by immunohistochemical methods. Chromogranin (Cg) A-, serotonin-, insulin-, glucagon-, somatostatin-, bovine pancreatic polypeptide (BPP)- and human pancreatic polypeptede (HPP)-immunoreactive cells were identified in this study. Most of immunoreactive cells in the exocrine and endocrine pancreas (Langerhans islet) were generally spherical or spindle-shaped (open-typed cell), while occasionally cells round in shape (close-typed cell) were found in the basal portion or interepithelial regions of the pancreatic duct. These immunoreactive cells were located in the exocrine, endocrine pancreas and/or basal or interepithelial portion of the pancreatic duct. Serotonin-immunoreactive cells were found in the basal portion of epithelia of the pancreatic duct at a low frequency and interacinar region of the exocrine at a moderate frequency. Insulin-immunoreactive cells were found in the central portion of the endocrine pancreas, interacinar regions of the exocrine pancreas and basal portion of the epithelia of the pancreatic duct at high, moderate and low frequencies, respectively. Glucagon-immunoreactive cells were detected in the periphery of the endocrine pancreas, interacinar region of the exocrine pancreas and basal portion of the epithelia or interepithelia of the pancreatic duct at high, moderate and moderate frequencies, respectively. Somatostatin-immunoreactive cells were dispersed in the whole area of the endocrine pancreas, interacinar regions of exocrine pancreas and basal portion of the epithelia or interepithelia of the pancreatic duct at a moderate frequency. BPP- and HPP-immunoreactive cells were detected in the iinteracinar region of the exocrine pancreas at moderate and hige frequencies, respectively. However, no Cg A- and motilin-immunoreactive cells were detected in this study.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.51-55
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• 2016

Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.

• Clinical Endoscopy
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• v.57 no.1
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• pp.96-104
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• 2024

Background/Aims: Selective bile duct or pancreatic duct cannulation remains a significant initial hurdle in endoscopic retrograde cholangiopancreatography (ERCP) despite advances in endoscopy and accessories. This study evaluated our experience with a rotatable sphincterotome in cases of difficult cannulation. Methods: We retrospectively reviewed ERCP cases using TRUEtome, a rotatable sphincterotome, as a rescue device for cannulation at a cancer institute in Japan from October 2014 to December 2021. Results: TRUEtome was used in 88 patients. Duodenoscopes were used for 51 patients, while single-balloon enteroscopes (SBE) were used for 37 patients. TRUEtome was used for biliary and pancreatic duct cannulation (84.1%), intrahepatic bile duct selection (12.5%), and strictures of the afferent limb (3.4%). Cannulation success rates were similar in the duodenoscope and SBE groups (86.3% vs. 75.7%, p=0.213). TRUEtome was more commonly used in cases with steep cannulation angles in the duodenoscope group and in cases requiring cannulation in different directions in the SBE group. There were no significant differences in adverse events between the two groups. Conclusions: The cannulation sphincterotome was useful for difficult cannulations in both unaltered and surgically altered anatomies. It may be an option to consider before high-risk procedures such as precut and endoscopic ultrasound-guided rendezvous techniques.