OBJECTIVE: To examine the feasibility and safety of a new rapid method of pancreaticogastrostomy, \"bridging\" pancreaticogastrostomy.
METHODS: Ten Landrace pigs were randomized into the experimental and control groups, with five pigs in each group. \"Bridging\" pancreaticogastrostomy was performed in the experimental group, while routine mucosa-to-mucosa pancreaticogastrostomy was performed in the control group. After surgery, the general condition, amylase levels in drainage fluid on Days 1, 3, 5, and 7, fasting and 2-h postprandial blood glucose 6 mo after surgery, fasting, 2-h postprandial peripheral blood insulin, and portal vein blood insulin 6 mo after surgery were assessed. Resurgery was carried out at 1 and 6 mo after the former one to examine the condition of the abdominal cavity and firmness and tightness of the pancreaticogastric anastomosis and pancreas.
RESULTS: After surgery, the general condition of the animals was good. One in the control group did not gain weight 6 mo after surgery, whereas significant weight gain was present in the others. There were significant differences on Days 1 and 3 after surgery between the two groups but no differences on Days 5 and 7. There were no differences in fasting and 2-h postprandial blood glucose and fasting and 2-h insulin values of postprandial peripheral blood and portal vein blood 6 mo after surgery between the two groups. One month after surgery, the sinus tract orifice/anastomosis was patent in the two groups. Six months after surgery, the sinus tract orifice/anastomosis was sealed, and pancreases in both groups presented with chronic pancreatitis.
CONCLUSIONS: \"Bridging\" pancreaticogastrostomy is a feasible and safe a means of damage control surgery during the early stage of pancreatic injury.
目的:为了研究一种新的快速胰胃吻合术方法的可行性和安全性,“桥接”胰胃吻合术。
方法:将10头长白猪随机分为实验组和对照组,每组五头猪。实验组进行“桥接”胰胃吻合术,对照组进行常规的粘膜-粘膜胰胃吻合术。手术后,一般情况,术后第1、3、5和7天引流液中的淀粉酶水平,术后6个月空腹和餐后2小时血糖,禁食,餐后2小时外周血胰岛素,术后6个月进行门静脉血胰岛素评估。在前者之后的1和6个月进行了复苏,以检查腹腔的状况以及胰胃吻合和胰腺的坚固性和紧密度。
结果:手术后,动物的一般状况很好。对照组中的一个在手术后6个月没有体重增加,而其他动物的体重显著增加。两组之间在手术后第1天和第3天存在显着差异,但在第5天和第7天没有差异。两组患者术后6个月的空腹和餐后2小时血糖以及餐后外周血和门静脉血的空腹和2小时胰岛素值无差异。手术后一个月,两组的窦道口/吻合术均为通畅。手术后六个月,窦道口/吻合口密封,两组的胰腺均出现慢性胰腺炎。
结论:“桥接”胰胃吻合术是胰腺损伤早期损伤控制手术的一种可行且安全的手段。