| Pancreaticoduodenectomy is the one and only way to radically cure the cancers of pancreas, bileduct and duodenum. But this procedure is complex and possesses much syndrome, and pancreatic fistula is the one of the most dangerous syndrome. In order to increase the success rate of pancreaticojejunostomy, reduce symdrome and death rate, doctors have increasingly focused on the research of pancreaticojejunostomy. Carrying out the pancreaticoduodenectomy by means of anastomat is one of the important part. In this thesis, a pancreaticojejunostomy anastomat was designed and studied, using methyl vinyl silicone rubber as matrix, benzoyl peroxide as vulcanizing agent, polymethylhydrosiloxane as crosslink agent, gaseous phase silicon dioxide as reinforcing filling, dihydroxydiphenylsilane as structural control agent silica, and quaternary ammonium hydroxide as catalyst agent. Anastomat was prepared the through one step of vulcanization with above materials and pre-embedded titanium nails.Molecular structure of anastomat was investigated with Fourier transform infrared spectroscopy(FTIR). Thermal properties were analyzed by thermal gravimetric analyzer(TGA) and hot air aging testing. Mechanical properties such as tensile strength and break elongation rate were tested also. Chemical corrosion resistance was testing by contacting water, alcohol and dioxygen water. Living body operation was carried out by cutting jejunum, breaking mucous membrane, pancreas setting into the jejunum, anastomat enwrapping anastomosing part, and fixing the anastomat. The position of titanium nails of anastomat was observed by abdomen X ray. Hyperplasia of fibrous tissue between the pancreas and intestines wall was analyzed by pathology. The changes of organics were observed by anatomy.The results show that: hydrosilicenae addition reaction between-Si-H of polymethylhydrosiloxane and-C=C of methyl vinyl silicone rubber was confirmed by FTIR. The birdnesting of gaseous phase silicon dioxide was disappeared by adding dihydroxydiphenylsilane, and the appearance of anastomat was smooth and uniform. The size of anastomat was 16 cm long, 1cm wide and 0.2cm thick, and the length could be pruned according to the focus part. Breaking elongation rate and tensile strength were 282.6% and 2.17 MPa, and the decreasing rate of breaking elongation rate and tensile strength were only 25.6%' 2.3% after enduring 280℃×6h hot air. Td(5wt%) was 429.9℃. The appearance of anastomat after sterilizing in oxirane and testing in the distilled water, 75% alcohol, 3% dioxygen water, NaOH(pH=9) and HCl(pH =0.8)did not change, and the weight loss only were 5.63%、1.52%、4.08%、5.20% and 2.26%, respectively. Medical analysis shows that the titanium nail of anastomat pierce the interior of pancreas symmetrically and vertically without falling off, degradation and shifting. A mount of fibrin hyperplasied between the pancreas and intestinal wall, and the blood circulation of duodenum and pancreas had already been normal in the tenth days after surgery, without pancreatic fistula, obvious strut, abscess, bleeding and no ascites in the abdominal cavity.According to our research, methyl vinyl silicone rubber could be used to prepare anastomat due to physiological non-toxic, and satisfied all of the request and index. Comparing with traditional pancreaticojejunostomy, the anastomotic stoma is of good quality, easily operating by surgeon and lasting short time. All of above illustrated that carrying out pancreaticojejunostomy by using of anastomat was a successful and doable way. In addition, this study not only strengthens the communication between materials science and biomedicine, but also provides a new reference for the future direction of new materials. |
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