Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function.

Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function. Research Abstract Details 

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Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function. Abstract Text:

Ming-Dong Bai,Liang-Qun Rong,Lian-Chen Wang,Hai Xu,Rui-Fang Fan,Pei Wang,Xiao-Peng Chen,Liu-Bin Shi,Shu-You Peng,Ming-Dong Bai,Liang-Qun Rong,Lian-Chen Wang,Hai Xu,Rui-Fang Fan,Pei Wang,Xiao-Peng Chen,Liu-Bin Shi,Shu-You Peng,

AIM: To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. After 4 wk ligation, a total of 36 piglets were divided randomly into four groups. The piglets in the control group underwent laparotomy only; the others were treated by three anastomoses: (1) end-to-end pancreaticojejunostomy invagination (EEPJ); (2) end-to-side duct-to-mucosa sutured anastomosis (ESPJ); or (3) binding pancreaticojejunostomy (BPJ). Anastomotic patency was assessed after 8 wk by body weight gain, intrapancreatic ductal pressure, pancreatic exocrine function secretin test, pancreatography, and macroscopic and histologic features of the anastomotic site. RESULTS: The EEPJ group had significantly slower weight gain than the ESPJ and BPJ groups on postoperative weeks 6 and 8 (P < 0.05). The animals in both the ESPJ and BPJ groups had a similar body weight gain. Intrapancreatic ductal pressure was similar in ESPJ and BPJ. However, pressure in EEPJ was significantly higher than that in ESPJ and BPJ (P < 0.05). All three functional parameters, the secretory volume, the flow rate of pancreatic juice, and bicarbonate concentration, were significantly higher in ESPJ and BPJ as compared to EEPJ (P < 0.05). However, the three parameters were similar in ESPJ and BPJ. Pancreatography performed after EEPJ revealed dilation and meandering of the main pancreatic duct, and the anastomotic site exhibited a variable degree of occlusion, and even blockage. Pancreatography of ESPJ and BPJ, however, showed normal ductal patency. Histopathology showed that the intestinal mucosa had fused with that of the pancreatic duct, with a gradual and continuous change from one to the other. For EEPJ, the portion of the pancreatic stump protruding into the jejunal lumen was largely replaced by cicatricial fibrous tissue. CONCLUSION: A mucosa-to-mucosa pancreatico-jejunostomy is the best choice for anastomotic patency when compared with EEPJ. BPJ can effectively maintain anastomotic patency and preserve pancreatic exocrine function as well as ESPJ.

Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function. Publishing Authors By Initials

MD Bai,LQ Rong,LC Wang,H Xu,RF Fan,P Wang,XP Chen,LB Shi,SY Peng,MD Bai,LQ Rong,LC Wang,H Xu,RF Fan,P Wang,XP Chen,LB Shi,SY Peng,

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Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: World journal of gastroenterology : WJG

VOLUME: 14

Page Numbers: 441-7

Journal Abbreviation: World J. Gastroenterol.

ISSN: 1007-9327

DAY: 21

MONTH: Jan

YEAR: 2008

Experimental study on operative methods of pancreaticojejunostomy with reference to anastomotic patency and postoperative pancreatic exocrine function. Information

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LANGUAGE: eng

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AFFILIATION: Department of General Surgery, The Second Affiliated Hospital, Xuzhou Medical College, Xuzhou 221006, Jiangsu Province, China. bmingdong@163.com.

Country: China

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MEDLINETA: World J Gastroenterol

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