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胰腺移植是新近发展起来的一种治疗用胰岛素不能控制的糖尿病的方法,但疗效尚待改进。失败的主要原因:一是术式尚未定型,二是术后排斥反应很难控制。手术中关键问题是:供胰的外分泌腺处理方法尚未臻美,胰管结扎、胰管和肠道吻合或/和泌尿道吻合,均可发生胰瘘、胰腺炎等并发症使移植失败。目前较多应用的是胰管开放和胰管用栓塞剂予以阻塞。我所于1980年起开始作狗胰腺移植模型。历经下列对照实验:①胰腺横断术,使胰管开放,胰液畅流至腹腔;②胰大部切除术,留存胰尾,胰管也开放。二组均证明,只要腹腔无污染与感染,胰酶不被激活,术后胰外泌液逐渐自行停止,不会发生腹膜炎或腐蚀其他脏器等并发症。而胰大部切除术后还证明:留存胰尾(全胰1/3),足以维持正常血糖。③全胰切除的
Pancreatic transplantation is a newly developed method of treating diabetes that can not be controlled by insulin, but the effect needs to be improved. The main reason for the failure: First, surgical procedures have not yet finalized, and second, rejection after surgery is difficult to control. The key question of the operation is that the treatment of exocrine glands for pancreas has not yet reached the threshold of the United States. Ligation of the pancreatic duct, anastomosis of the pancreatic duct and intestinal tract, and / or anastomosis of the urinary tract can all lead to the failure of transplantation such as pancreatic fistula and pancreatitis. Currently more applications of pancreatic duct is open and pancreatic duct embolization agent to be blocked. I started in 1980 as a model of dog pancreas transplantation. After the following control experiments: ① pancreatic transection, the pancreatic duct open, pancreatic fluid flow to the abdominal cavity; ② pancreatectomy, pancreatic tail retention, pancreatic duct is also open. Two groups have proved that as long as no pollution and infection of the abdominal cavity, trypsin is not activated, postoperative pancreatic excretion gradually stopped on their own, does not occur peritonitis or other complications of corrosion of other organs. The majority of pancreatic resection also proved: retained pancreatic tail (pancreas 1/3), enough to maintain normal blood sugar. Total pancreatectomy