[Pathophysiology during follow-up after extensive pancreatectomy]

In 20 cases of total pancreatectomy and 74 cases of pancreaticoduodenectomy, pancreatic endocrine and exocrine functions in long-term survival after surgery were investigated, particularly in relation to development of fatty liver, metabolic bone disorder and changes of serum zinc. In cases of pancreaticoduodenectomy, although the residual pancreatic endocrine and exocrine functions decreased in 1 or 2 months, they were recovered within a year and these functions were maintained relatively well, but in cases of resection of fibrotic pancreas, they decreased gradually in more than 3 years after surgery. In a long-term survival, fatty liver, metabolic bone disorder and an impaired absorption of zinc developed, and such changes occurred remarkably in cases of resection of fibrotic pancreas or in cases of total pancreatectomy. Hence, after major resection of the pancreas, a long-term sufficient control should be necessary understanding these pathophysiology.