An experimental study on the etiologic effect of pancreas divisum on chronic pancreatitis and the pathogenesis

doi:10.3969/j.issn.1006-9011.2001.01.007

Abstract：Objective:To clarify the etiologic assodation of pancreas divisurn(PD)with chronic pancreatitis and the pathogenesis. Methods:A canine model of PD was established in 32 dogs. The dogs were randomly divided into 4 groups(each n = 8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic duct was partly ligated remaining a 1.0 mm diameter.Group Ⅱ a:The communicating branch was amputated and ligated. Group Ⅱ b:The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group m: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipases A2 (PLA2)and amylase (Ams)were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were performed. Resuits: (1)The activities of serum PLA2 and Ams in Group Ⅰ , Ⅱ a and 11 b were significantly increased 5～80 days after operation. (2)At sacrifice,the basal pressures of the ventral duct were significantly increased 3060 min after provocation in Group Ⅰ , Ⅱ a and Ⅱ b, especially in Group Ⅱ b, the pressures returned to the normal level till 90 min. The pressures of the dorsal duct were significantly increased in Group Ⅱ b but no difference in Group Ⅰ and Ⅱ a. (3)Light microscope:The fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱ b. But in Group Ⅰ and Ⅱ a, this findings were present only in the ventral pancreas. (4) Electron microscope: In ventral pancreas of Group Ⅰ and Ⅱ a and the dorsal and ventral pancreas of Group Ⅱ b, the rough endoplasmic reticulum of the acinar cells showed granules- scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. Conclusion: A difinite etiologic relationship was confirmed between PD and chronic pancreatitis. The pathogenesis was due to the functional obstruction of the minor papilla at the peak stage of secretion.