Animal Research Of Pancreatic Duct Jejunum Anastomosis Bridge

Objective: Research of pancreatic-duct into the Jejunum stump on pancreaticojejunostomy type-pancreatic-duct /Jejunum-stump anastomosis -by the animal experiments ,to investigate its feasibility and the advantage of preventing pancreatic leakage in the pancreatic head duodenectomy.Method: 16 North mongrel dogs were divided into experimental group (EG, n=10) and control group (CG, N=6). EG were implement pancreatic-duct /Jejunum-stump anastomosis. CG were implement pancreas/jejunum-stump anastomosis in full mouth and thickness . Preoperative testing weight ,value of blood glucose and levels of serum amylase. Observed pancreatic shape, texture and measured pancreatic-duct diameter in pancreatic surgery, and recorded pancreatojejunostomy time. Two months after surgery, observed the general status of spirit, diet, defecation and others. peritoneal drainage, and the nature of the test the first 5 days after the first 10 days of intraperitoneal drainage fluid amylase values; respectively after 1, 3,7,14 days and 28 days, serum amylase, levels of glucose. After two months, the survival of canine body weight measurement;testing blood glucose and serum amylase values. Survival of dogs were sacrificed to check whether the ascites and peritoneal adhesions; observation of pancreatic anastomosis healing and changes in texture of pancreas; measurement of pancreatic duct diameter. Anastomotic tissue specimens from pancreatic histopathological examinations. Experiments involvingassessment of the data using t test significant differences.Results: 16 dogs in North China before surgery weight 13.45±3.25kg; experimental group before glucose 4.15±1.32mol/ml, serum amylase value of 927±135.25IU / L. Observed in pancreatic surgery pink, pancreas V shaped mostly slender, soft; duct diameter of 0.215±0.026cm; experimental group of 10 dogs were successfully bridging the pancreatic duct jejunum anastomosis, the average match time of 18.6min. 6 dogs in control group the successful completion of the pancreas - the whole mouth full thickness jejunum end to side anastomosis, the average match time of 30.2min. Two months after feeding the experimental group, two dogs died halfway, died of anesthetic accident, the body detect pancreatic anastomotic integrity, and no obvious signs of pancreatic leakage; control group, one dog died three days after surgery, body exploration see pancreatic necrosis, abdominal large effusion, ascites amylase check 12182 IU / L, a diagnosis of postoperative pancreatic leakage. Because of poor compliance in dogs and can not accurately observe the drainage, and character; Part 5 days after peritoneal drainage tube has prolapse with or without abdominal drainage fluid extraction, determination of the experimental group only 5 dogs in the peritoneal drainage fluid amylase value of 1938.5±489.56IU / L, control group, 3 dogs measured peritoneal drainage fluid amylase value of 2162.5±562.50IU / L, were lower than the mean preoperative value of serum amylase 3 times, after the first 10 days all the abdominal drainage tube prolapse have been unable to Determination of peritoneal drainage fluid amylase. Two months after surviving 13 dogs, 8 dogs weight gain, weight loss, 5 dogs; experimental group blood glucose levels after two months of 4.78±1.46mol / ml, compared with no significant preoperative difference changes (P> 0.05 .) Survival of dogs were killed, see intra-abdominal adhesions in varying degrees, mild adhesion of pancreatic anastomosis and found no limitations effusion, pseudocysts and necrosis; pancreatic anastomotic continuity, bainitic pancreatic atrophy, pancreatic duct dilatation (diameter of 0.482±0.156cm), compared with preoperative changes are significant differences (P <0.05): pancreatic anastomotic pancreatic histopathological see the formation of intestinal anastomosis strong fiber connections, duct patency, pancreatic duct expansion with marked hyperplasia of the surrounding fibrous tissue, pancreatic fibrosis, atrophy. Pathological examination showed the control group were pancreatic stump mucosa and proliferation of fibrous tissue coverage, dilatation of pancreatic duct with fibrous tissue proliferation.Conclusion: The preliminary results confirm a bridge duct jejunum anastomosis (pancreatic duct into the jejunum end to side anastomosis) surgical operation is simple, consistent with a short time .2. By experimental observation that the pancreatic duct jejunum anastomosis, anastomotic healing bridge Good, anastomotic patency is good, the experimental group animals without pancreatic leakage occurred; pancreatic duct jejunum anastomosis is a safe bridge the pancreas jejunum anastomosis. 3. This study observed that the residual pancreatic duct expansion of different levels, pancreatic fibrosis, pancreatic bainitic atrophy, suggesting that internal and external secretory function of the pancreas may have different degrees of reduction.