Showing papers by "Tadahiro Takada published in 1989"
TL;DR: The above findings indicate that the duodenal bulb and the gastric antrum seem to play important roles in the gut hormonal release and that the pylorus-preserving operation is the superior surgical technique in terms of gastrin and secretin release.
Abstract: Based on the observation that patients given a pylorus-preserving pancreatoduodenectomy maintain higher gut hormonal levels than do patients who have received the classic Whipple surgical procedure, which seems most likely due to a postoperative difference in the remaining digestive tract, the postprandial plasma gastrin and secretin concentrations in patients who have received either surgery have been evaluated to examine this difference more fully. The subjects were 20 patients treated by a pylorus-preserving operation and 27 patients treated by the Whipple procedure whose concentrations were compared with those of 8 healthy control patients. The postprandial plasma gastrin concentrations were found to be similar in patients given the pylorus-preserving operation and the controls and were significantly lower in patients who underwent the Whipple procedure (p less than 0.05). Similarly, the postprandial plasma secretin concentrations did not differ in these two groups, whereas patients who underwent the Whipple procedure showed significantly lower concentrations at 60, 90, and 120 minutes (p less than 0.05). The above findings, as well as supportive data in the literature, indicate that the duodenal bulb and the gastric antrum, which are resected in the Whipple procedure and are kept in the pylorus-preserving operation, seem to play important roles in the gut hormonal release and that the pylorus-preserving operation is the superior surgical technique in terms of gastrin and secretin release.
64 citations
TL;DR: The results suggest that experimental chronic biliary dilatation can be produced by two approaches: 1) Blockage of bile flow in the papilla or the bile duct, and 2) detachment of the biliary duct without disturbing biliary flow.
Abstract: The factors inducing biliary dilatation were studied morphologically and functionally by cholangiography and cholangiomanometry in experimental models of chronic biliary dilatation. These models were produced by four methods: Constriction of the lower bile duct (Group 1), formalin infusion into the duodenal papilla (Group 2), detachment of the extrahepatic bile duct (Group 3), and sphinc-terotomy (Group 4). Biliary dilatation was observed in the first three groups but not in the fourth group. An increase in the intraductal pressure due to blockage of the biliary outflow tract was considered to be the cause of biliary dilatation in Group 1 and 2. In Group 3, the function of the lower bile duct, including the papilla was intact, and reduced resistance of the bile duct wall and due to the loss of the support from the surrounding connective tissue was considered to have induced biliary dilatation. These results suggest that experimental chronic biliary dilatation can be produced by two approaches: 1) Blockage of bile flow in the papilla or the bile duct, and 2) detachment of the bile duct without disturbing bile flow.