PDF(Pubmed)
Abstract：
BACKGROUND: In recent years, we created and employed a new anastomosis method, \"bridging\" pancreaticogastrostomy, to treat patients with extremely severe pancreatic injury. This surgery has advantages such as short length of surgery, low secondary trauma, rapid construction of shunts for pancreatic fluid, preventing second surgeries, and achieving good treatment outcomes in clinical practice. However, due to the limited number of clinical cases, there is a lack of strong evidence to support the feasibility and safety of this surgical procedure. Therefore, we carried out animal experiments to examine this procedure, which is reported here.
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.
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.
摘要：
背景：近年来，我们创造并采用了一种新的吻合方法，“桥接”胰胃吻合术，治疗胰腺损伤极其严重的患者。这种手术具有手术时间短等优点，低继发性创伤,快速构建胰液分流器，防止第二次手术，并在临床实践中取得良好的治疗效果。然而,由于临床病例数量有限，缺乏强有力的证据支持这种外科手术的可行性和安全性.因此,我们进行了动物实验来检查这个程序，这是在这里报道的。
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。
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。
