1990 Volume 51 Issue 12 Pages 2633-2637
This study was made to search for a more physiological reconstructive method following pancreatoduodenectomy between Imanaga and Child proeedures, which have been commonly employed in our department. Postoperative outcome was evaluated by various examinations, such as 75g OGTT, PFD and double scintigraphy method with simultaneous use of99m Tc-PMT for hepatobiliary flow and 111In-DTPA for gastrointestinal flow. From the point of glucose tolerance test in 75g OGTT, Imanaga procedure was superior to Child procedure. In insulinogenic index, Imanaga was slightly superior to the other as shown by the index of 0.43±0.07 for Imanaga versus 0.33±0.08 for Child. Imanaga was also significantly superior to Child in PFD tests, showing 75.3±7% by Imanaga versus 58.4±4% by Child. Hepatobiliary scintigraphy revealed a prominent stasis by Child procedure, whereas no stasis by lmanaga. Double scintigraphy showed that the time required before the mixture of the two agents at the jejunum in Imanaga was similar to the control while it was apparently longer in Child. These data suggested that Imanaga procedure is more physiological and maintain the residual pancreatic function compared toChild procedure.
