Gradient inflammation in the pancreatic stump after pancreaticoduodenectomy:Two case reports and review of literature  

作　　者：Tie-Gong Wang Liang Tian Xiao-Ling Zhang Lei Zhang Xiu-Lei Zhao De-Shuai Kong 

机构地区：[1]Department of Surgery,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China [2]Department of Pathology,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China

出　　处：《World Journal of Clinical Cases》2024年第9期1649-1659,共11页世界临床病例杂志

摘　　要：BACKGROUND Postoperative pancreatic fistula(POPF)contributes significantly to morbidity and mortality after pancreaticoduodenectomy(PD).However,the underlying mechanisms remain unclear.This study explored this pathology in the pancreatic stumps and elucidated the mechanisms of POPF following PD.CASE SUMMARY Pathological analysis and 16S rRNA gene sequencing were performed on specimens obtained from two patients who underwent complete pancreatectomy for grade C POPF after PD.Gradient inflammation is present in the pancreatic stump.The apoptosis was lower than that in the normal pancreas.Moreover,neu-trophildominated inflammatory cells are concentrated in the ductal system.No-tably,neutrophils migrated through the ductal wall in acinar duct metaplasia-formed ducts.Additionally,evidence indicates that gut microbes migrate from the digestive tract.Gradient inflammation occurs in pancreatic stumps after PD.CONCLUSION The mechanisms underlying POPF include high biochemical activity in the pancreas,mechanical injury,and digestive reflux.To prevent POPF and address pancreatic inflammation and reflux,breaking the link with anastomotic dehi-scence is practical.

关 键 词：PANCREATICODUODENECTOMY Postoperative pancreatic fistula INFLAMMATION Digestive reflux Case report 

分 类 号：R735.9[医药卫生—肿瘤]