膵切除症例におけるprostaglandin E1周術期投与の膵保護効果

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  • PANCREATIC CYTOPROTECTIVE EFFECTS OF PROSTAGLANDIN E1 IN PANCREATECTOMIZED PATIENTS

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We studied the changes in serum levels of pancreatic enzymes during perioperative period of patients undergoing pancreatic surgery to examine the cytoprotective effect of prostaglandin E1 (PGE1) with improvement of pancreatic micro-circulation. Subjects were 16 patients who underwent pancreatectomy or gastrectomy with extended removal of lymph nodes surrounding the pancreas. They were randomly divided into a group treated with PGE1 comprising of 8 patients and control group comprising of another 8 patients. Primary diseases involved 9 advanced gastric cancers, 3 bile-duct or pancreatic cancers, and 4 pancreatic cystadenomas. PGE1 was continuously given at a dose of 0.01μg/kg/min from the start of surgery until 24 hours after the surgery. Gabexate mesilate was given to each group at a dose of 400mg/day for 5 days. The incidence of abnomally high levels of serum pancreatic amylase on the seventh day after the surgery was 88% in control and 13% in PGE1 group, with a significant difference (p<0.05). Postoperative levels of pancreatic amylase and trypsin were significantly lower in the PGE1 gruop than control group (p<0.05). These results suggest that perioperative administration of PGE1 may provide effective pancreatic cytoprotection and consequent prevention against acute pancreatitis following surgery which has a high motality rate.

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