Microcirculation in chronic alcoholic pancreatitis: A laser Doppler flow study

Experimental chronic pancreatitis is associated with microcirculatory distu rbances but can also be induced or aggravated by perfusion changes. Microci rculatory alterations in human chronic pancreatitis are poorly defined. In this clinical study we investigated pancreatic microcirculation in the norm al human pancreas and in chronic pancreatitis by laser Doppler flowmetry. L aparotomy was performed on 13 patients with nonpancreatic disease and on ni ne patients with chronic alcoholic pancreatitis for pancreatic head resecti on. Blood flow was measured over the pancreatic head, the uncinate process, over the mesenteric vein, the pancreatic corpus, and over the pancreatic t ail by laser Doppler flowmetry. Blood flow was highest in the head of a nor mal pancreas with a mean of 436 +/- 34 perfusion units (PU), 399 +/- 43 PU in the uncinate process, 286 +/- 30 PU in the pancreatic corpus, and 351 +/ - 46 PU in the tail of the pancreas. In the normal pancreas, lowest blood f low was measured over the mesenteric vein (228 +/- 23 PU). In chronic pancr eatitis, blood flow in the pancreas was significantly decreased across the whole pancreas (p < 0.01). Furthermore flow-wave pattern was altered in chr onic pancreatitis as compared with the normal pancreas. The normal human pa ncreas has a spatial variation in blood flow, correlating with the pancreat ic arterial blood supply. In the chronically inflamed human pancreas, blood flow is significantly diminished, with a lower now toward the pancreatic h ead.