Abstract:Objective: To assess the feasibility and safety of the interrupted running-through suture pancreaticojejunostomy though an animal experiment, for providing an experimental basis for clinical application.
Methods: Twenty experimental pigs were equally randomized into study group and control group, and then underwent interrupted running-through suture or pancreatic duct-to-jejunal mucosa anastomosis to establish the pancreaticojejunostomy models. In the two groups, the time for pancreaticojejunostomy and the amylase level in the drainage tube on postoperative day 3 were recorded, and the anastomotic stomas were cut off one week after operation for pathological examination and immunohistochemical staining of smooth muscle actin (SMA).
Results: The time to perform pancreaticojejunostomy was significantly reduced in study group compared with control group [(14.0±3.6) min vs. (20.9±3.2) min, P<0.05]. Although there was no statistical significance in the overall incidence of postoperative pancreatic fistula between the two groups (11.1% vs. 40.0%, P>0.05), only one case of grade A pancreatic fistula was noted in study group, while 2 cases each of grade B and C pancreatic fistula occurred in control group. The results of pathological examination showed that the inflammation in the anastomotic stoma was milder and the attachment of the jejunal wall to the pancreatic stump was tighter in study group than those in control group, and the positive rate of SMA immunohistochemical staining was significantly higher in study group than that in control group (88.9% vs. 20%, P<0.05).
Conclusion: Compared to the traditional pancreatic duct-to-jejunal mucosa anastomosis, the interrupted running-through suture pancreaticojejunostomy has the advantages of being easy to perform, reduced anastomosis time, reliable fixation, and decreased incidence of pancreatic fistula. So, it is recommended to be used in clinical practice.