A sutureless method for digestive tract reconstruction during pancreaticoduodenectomy in a dog model

摘要

Development of pancreatic fistulas as a result of anastomotic gaps is still a major complication after pancreaticoduodenectomy, and can cause post-operative death. Therefore, safer and more effective methods of anastomosis are needed to avoid leakage and decrease mortality. Materials and methods: Twenty domestic dogs with body weights ranging from 15 to 25 kg were used, regardless of gender. A model of common bile duct and pancreatic duct dilatation was surgically prepared in these dogs. Pancreaticobiliary stents combined with magnetic anastomoses (PB-MA), and controls were treated with fibrin glue were studied in terms of and efficacy by measurement of serum amylase, incidence of complications, and survival times. Results: The mean time required to create the fibrin glue pancreaticoenterostomy was 9 ± 2.05 min, while the mean time required to create the magnet cholangioenterostomy was 5 ± 0.9 min. The total operative time was 2.7 ± 0.6 h. Eighty percent of the dogs that underwent the operations were still alive for 15 days after the operations and none developed pancreatic fistulas. Examination by macroscopic observation, and hematoxylin and eosin staining of the pathological specimens showed that the anastomoses were completed healed. Conclusions: The use of a PB-MA in sutureless digestive tract reconstruction for pancreatoduodenectomy resulted in an elimination of pancreatic fistulas, and shortening of the stent removed time. In addition, the procedure is simple to perform, fast, and appears to be safe in this dog model.