Epidermal growth factor is critical for intestinal adaptation following small bowel resection

High Values of Drain Fluid Epidermal Growth Factor and Transforming Growth Factor-Beta Are Associated with the Development of Pancreatic Fistula after Pancreatoduodenectomy

INTRODUCTION

Postoperative inflammatory response may act as a major determinant of anastomotic failure after pancreaticoduodenectomy. In this pilot study, we investigated the potential role of drain fluid cytokines in predicting postoperative pancreatic fistula (POPF).

METHODS

Drain fluid TGF-β, IGF-1, EGF, and IL-6, together with serum amylase and drain fluid amylase, were measured on POD1 and correlated with the development of POPF.

RESULTS

The study population consisted of 66 patients. POPF and Clavien-Dindo ≥3 morbidity rates were 12.1% and 9.1%, respectively. Patients developing POPF presented significantly higher values of POD1 serum amylase level (477 vs. 54 UI/L, p < 0.001), drain fluid amylase (7,500 vs. 127 UI/L, p < 0.001), TGFβ (94 vs. 40 pg/g, p = 0.045), and EGF (17 vs. 13, p = 0.015). There were no differences in terms of IGF-1 and IL-6 values.

CONCLUSION

Assessing the local inflammatory response after pancreatoduodenectomy could represent a promising field of research since both TGFβ and EGF seem to be associated with the occurrence of POPF.

Progress in the treatment of intestinal barrier dysfunction

Intestinal barrier function plays a pivotal role in the development and progression of some severe diseases such as severe burn, severe acute pancreatitis, tumors, and severe liver disease. With a gradual understanding of the role of intestinal barrier dysfunction in the pathophysiology of various severe diseases, scholars have paid more attention to the basic and clinical research of the treatment of intestinal barrier function. This paper will review the latest advance in the treatment of intestinal barrier dysfunction.