Dynamic MR Cholangiopancreatography Using Secretin Stimulation in Evaluation of Pancreatic Exocrine Function after Pancreatograstrostomy

Seiji Ohhigashi and Takeki Nishio

Department of Surgery, St. Luke's International Hospital

The purpose of this study was to assess the utility of dynamic MR cholangiopancreatography (MRCP) in evaluation of pancreatic exocrine function after pancreatogastrostomy. The cases of two patients who underwent pylorus-preserving pancreatoduodenectomy reconstructed by pancreatogastrostomy with the help of a tube pancreatostomy were analyzed. Abdominal CT disclosed no particular change in the remnant pancreas, and endoscopy detected no orifice of the residual pancreatic duct. On the other hand, dynamic MRCP using secretin stimulation revealed secretion of pancreatic fluid. Moreover, the mean pixel value and the total intensity value that were caluculated by tracing the image of pancreatic fluid were useful in objectively estimating the changes in pancreatic fluid. Pancreatogastrostomy is easy and safe to perform, yet the likelihood of dysfunction of the pancreas due to pancreatic duct obstruction has been pointed out. Also, appropriate evaluation of the pancreatic exocrine function has often been difficult by conventional modalities. Using dynamic MRCP, however, made it possible not only to observe the image of pancreatic fluid clearly but to estimate objectively the kinetics of pancreatic fluid. Thus, this study demonstrated that dynamic MRCP after secretin stimulation was significantly useful in evaluating the residual pancreatic exocrine function after resection of the pancreas.

Key words
dynamic MRCP, secretin, pancreatogastrostomy

Reprint requests
Seiji Ohhigashi Department of Surgery, St. Luke's International Hospital 9-1 Akashi-cho Chuo-ku, Tokyo, 104-8560 JAPAN

Accepted
October 26, 1999

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