Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.871
Peer-review started: November 15, 2022
First decision: February 15, 2023
Revised: February 22, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 27, 2023
Rikkunshito (TJ-43) improves gastrointestinal disturbances.
The effects of TJ-43 in patients undergoing pancreatic surgery have not been elucidated.
This study investigated the effects of TJ-43 in patients undergoing pylorus-preserving pancreatico-duodenectomy (PpPD).
Forty-one patients who underwent PpPD were divided into two groups; patients treated with daily doses of TJ-43 after surgery [TJ-43(+) group] or just on postoperative day (POD) 21 [TJ-43(-) group]. Plasma levels of acylated and desacylated ghrelin, cholecystokinin (CCK), peptide YY (PYY), gastric inhibitory peptide (GIP), and active glucagon-like peptide (GLP)-1 were evaluated. Oral calorie intake was assessed at POD 21 in both groups. The primary endpoint of this study was the total food intake after PpPD.
The acylated-ghrelin levels were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 treatment at POD 21. Similarly, oral intake significantly increased in the TJ-43(+) group. The levels of CCK and PYY were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration. Furthermore, the GIP and active GLP-1 levels increased and the values at POD 21 were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 treatment. Insulin secretion tended to increase in patients treated with TJ-43.
TJ-43 may improve oral food intake in patients in the early phase after pancreatic surgery.
Further investigation is needed to clarify the effects of TJ-43 on incretin hormones.