Randomized Prospective Trial of the Effect of Induced Hypergastrinemia on the Prevention of Pancreatic Atrophy After Pancreatoduodenectomy in Humans
Abstract
OBJECTIVE: To investigate whether gastrin has regenerative effect on the pancreas and in particular whether it prevents the atrophy of the distal pancreas after resection of pancreas in humans. SUMMARY BACKGROUND DATA: Although pancreatic regeneration after resection is well documented in animals, atrophy rather than regeneration of the distal remnant pancreas commonly occurs following pancreatoduodenectomy in humans. Of the many factors involving pancreatic regeneration, gastrin has been shown to have trophic effect on the pancreas in an animal model. METHODS: Between March 1999 and May 2000, a randomized prospective study was performed in 56 patients who underwent pylorus-preserving pancreatoduodenectomy for periampullary neoplasms. Patients were allocated to either a lansoprazole group or a control group. The lansoprazole members were given oral lansoprazole (30 mg/d) over 12 weeks postoperatively to induce hypergastrinemia. During the study period, 19 patients were excluded for different reasons; in the end a total of 37 patients (lansoprazole, n = 18; control, n = 19) were eligible for study. The volume of the distal pancreas as determined using thin-sectioned spiral CT data, nutritional status, and endocrine (insulin level, glucose tolerance test) and exocrine function (stool elastase) of the pancreas and serum gastrin levels were measured before surgery and 3 months after surgery. The two groups were clinically comparable. RESULTS: Serum gastrin level was elevated in…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 56 participants or records.
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