切换至 "中华医学电子期刊资源库"
高级检索
中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2021, Vol. 10 ›› Issue (02) : 206 -209. doi: 10.3877/cma.j.issn.2095-3232.2021.02.018

所属专题： 文献；

基础研究

犬纤维蛋白胶粘结式胰肠吻合安全性研究
郝杰1, 雷鹏2, 张斌斌3, 吕毅1, 崔晓海4,†()   
  1. 1. 710061　西安交通大学第一附属医院肝胆外科；710061　西安，精准外科与再生医学国家地方联合工程研究中心
    2. 750000　银川，宁夏医科大学总医院肝胆外科
    3. 030000　太原，山西大医院肝胆外科
    4. 710061　西安，精准外科与再生医学国家地方联合工程研究中心；710061　西安交通大学第一附属医院胸外科
  • 收稿日期:2021-01-06 出版日期:2021-04-10
  • 通信作者: 崔晓海
  • 基金资助:
    陕西省重点研发计划(2018SF-022); 陕西省自然科学基础研究计划(2020JM-402)

Study on safety of conglutinant pancreaticojejunostomy with fibrin glue in dog models

Jie Hao1, Peng Lei2, Binbin Zhang3, Yi Lyu1, Xiaohai Cui4,†()   

  1. 1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National and Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, Xi'an 710061, China
    2. Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Yinchuan 750000, China
    3. Department of Hepatobiliary Surgery, Shanxi Bethune Hospital, Taiyuan 030000, China
    4. National and Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, Xi'an 710061, China; Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
  • Received:2021-01-06 Published:2021-04-10
  • Corresponding author: Xiaohai Cui
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

郝杰, 雷鹏, 张斌斌, 吕毅, 崔晓海. 犬纤维蛋白胶粘结式胰肠吻合安全性研究[J]. 中华肝脏外科手术学电子杂志, 2021, 10(02): 206-209.

Jie Hao, Peng Lei, Binbin Zhang, Yi Lyu, Xiaohai Cui. Study on safety of conglutinant pancreaticojejunostomy with fibrin glue in dog models[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(02): 206-209.

目的

探讨纤维蛋白胶粘结式胰肠吻合的可行性及安全性。

方法

选取10只家犬，于胰尾切除术后，采用纤维蛋白胶行粘结式胰肠吻合，分别于术前及术后1、3、7、10 d检测血清淀粉酶变化，并于术后10、30 d腹腔探查，取吻合口标本行病理学检查。

结果

粘结式胰肠吻合平均手术时间为（9.0±2.1）min。术前血清淀粉酶为（598±97）IU/L，术后10 d为（622±79）IU/L，术后无胰瘘发生。肉眼观察可见吻合口周围大网膜包裹，与周围组织广泛粘连，无胰瘘等形成；HE染色显示胰肠吻合口愈合良好，少量炎症细胞浸润。

结论

纤维蛋白胶用于犬粘结式胰肠吻合方法简单、操作简便、安全可靠，可有效缩短手术时间。

关键词: 犬, 胰十二指肠切除术, 胰管空肠吻合术, 纤维蛋白胶, 粘结式
Objective

To explore the feasibility and safety of conglutinant pancreaticojejunostomy using fibrin glue.

Methods

Conglutinant pancreaticojejunostomy using fibrin glue was performed after pancreatectomy in 10 dog models. The changes of serum amylase level were detected before and at 1-, 3-, 7- and 10 d after operation. Abdominal cavity exploration was conducted at postoperative 10- and 30 d. The anastomotic specimens were collected for pathological examination.

Results

The average operation time of conglutinant pancreaticojejunostomy was (9.0±2.1) min. The serum amylase level was (598±97) IU/L before operation and (622±79) IU/L at 10 d after operation. No pancreatic fistula occurred after operation. Macroscopic observation found that the anastomotic site was surrounded by omentum, which was widely adhered to the surrounding tissues. No pancreatic fistula and other complications were observed. HE staining demonstrated that the anastomotic site of pancreaticojejunostomy healed well and slight inflammatory cell infiltration was noted.

Conclusions

It is convenient, safe and reliable to apply fibrin glue in conglutinant pancreaticojejunostomy in dog models, which can effectively shorten the operation time.

Key words: Dog model, Pancreaticoduodenectomy, Pancreaticojejunostomy, Human fibrin glue, Conglutinant
图1 犬胰肠吻合手术图
图2 犬胰肠吻合口术后情况
图3 胰肠吻合口组织切片情况
[1]
Chen JS, Liu G, Li TR, et al. Pancreatic fistula after pancreaticoduodenectomy: risk factors and preventive strategies[J].J Cancer Res Ther, 2019, 15(4):857-863.
[2]
Fischer TD, Gutman DS, Hughes SJ, et al. Disconnected pancreatic duct syndrome: disease classification and management strategies[J]. J Am Coll Surgeons, 2014, 219(4):704-712.
[3]
Hashimoto Y, Traverso LW. After distal pancreatectomy pancreatic leakage from the stump of the pancreas may be due to drain failure or pancreatic ductal back pressure[J]. J Gastrointest Surg, 2012, 16(5):993-1003.
[4]
Klein F, Glanemann M, Faber W, et al. Pancreatoenteral anastomosis or direct closure of the pancreatic remnant after a distal pancreatectomy: a single-centre experience[J]. HPB, 2012, 14(12): 798-804.
[5]
Kawai M, Tani M, Okada KI, et al. Stump closure of a thick pancreas using stapler closure increases pancreatic fistula after distal pancreatectomy[J]. Am J Surg, 2013, 206(3):352-359.
[6]
Panni RZ, Guerra J, Hawkins WG, et al. National pancreatic fistula rates after minimally invasive pancreaticoduodenectomy: a NSQIP analysis[J]. J Am Coll Surg, 2019, 229(2):192-199, e1.
[7]
Iida H, Tani M, Maehira H, et al. Postoperative pancreatic swelling predicts pancreatic fistula after pancreaticoduodenectomy[J].Am Surg, 2019, 85(4):321-326.
[8]
Ke ZX, Xiong JX, Hu J, et al. Risk factors and management of postoperative pancreatic fistula following pancreaticoduodenectomy: single-center experience[J]. Curr Med Sci, 2019, 39(6):1009-1018.
[9]
Maggino L, Malleo G, Bassi C, et al. Decoding grade B pancreatic fistula: a clinical and economical analysis and subclassification proposal[J]. Ann Surg, 2019, 269(6):1146-1153.
[10]
Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies[J]. J Am Coll Surg, 2015, 220(4):530-536.
[11]
Pedrazzoli S. Pancreatoduodenectomy (PD) and postoperative pancreatic fistula (POPF): a systematic review and analysis of the POPF-related mortality rate in 60,739 patients retrieved from the English literature published between 1990 and 2015[J]. Medicine, 2017, 96(19):e6858.
[12]
Chen YJ, Lai EC, Lau WY, et al. Enteric reconstruction of pancreatic stump following pancreaticoduodenectomy: a review of the literature[J]. Int J Surg, 2014, 12(7):706-711.
[13]
Zhang H, Zhu F, Shen M, et al. Systematic review and meta-analysis comparing three techniques for pancreatic remnant closure following distal pancreatectomy[J]. Br J Surg, 2015, 102(1):4-15.
[14]
Xu J, Ji SR, Zhang B, et al. Strategies for pancreatic anastomosis after pancreaticoduodenectomy: what really matters?[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(1):22-26.
[15]
Shen Y, Jin W. Reconstruction by pancreaticogastrostomy versus pancreaticojejunostomy following pancreaticoduodenectomy:a meta-analysis of randomized controlled trials[J]. Gastroent Res Pract, 2012:627095.
[16]
Kleespies A, Albertsmeier M, Obeidat F, et al. The challenge of pancreatic anastomosis[J]. Langenbecks Arch Surg, 2008, 393(4): 459-471.
[17]
Orci LA, Oldani G, Berney T, et al. Systematic review and meta-analysis of fibrin sealants for patients undergoing pancreatic resection[J]. HPB, 2014, 16(1):3-11.
[18]
Follo F, Dejana DO, Belletti M, et al. Management and effect of platelet-rich plasma on wound healing: small reality of Oglio Po Hospital[J]. Acta Biomed, 2017, 88(5S):66-70.
[19]
江涛，黎介寿．纤维蛋白胶和生长激素促进腹腔感染条件下大鼠肠吻合口愈合的研究[J]．中华普通外科杂志，2002，17(3)：173-176.
[20]
陈建雄，霍枫，程黎阳，等. 粘结式胰肠吻合的临床对比研究[J]．实用医学杂志，2010，26(10)：1737-1740.
[1] 卢伶俐, 刘豪, 胡英, 何潇, 邓宏武, 何英, 张轶, 王勇, 万能斌. 带蒂大网膜联合硅胶假体乳房重建术后放射治疗的动物实验研究[J]. 中华乳腺病杂志(电子版), 2023, 17(02): 97-101.
[2] 韩青雷, 宋铭杰, 李佳隆, 邵英梅. 胰十二指肠切除术前不同减黄方式对术后并发症的影响[J]. 中华普通外科学文献(电子版), 2023, 17(02): 144-147.
[3] 李存权, 崔磊, 柳科军, 李政权, 刘俊豪, 卜阳. 胰十二指肠切除术后复杂腹腔感染的危险因素分析及病原菌构成[J]. 中华普通外科学文献(电子版), 2022, 16(06): 417-421.
[4] 王领, 于洁, 段红亮, 李德正. 不同手术路径在腹腔镜胰十二指肠切除术中钩突切除的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(02): 153-156.
[5] 韩显林. 完全腹腔镜根治性胰十二指肠切除术（联合肠系膜上静脉切除人工血管重建）[J]. 中华普外科手术学杂志(电子版), 2023, 17(02): 133-133.
[6] 郭艳, 张明, 牛河源, 孟兴凯. 胰十二指肠切除后消化道重建的动物模型选择[J]. 中华普外科手术学杂志(电子版), 2023, 17(01): 101-104.
[7] 赵长勇, 徐松, 饶敏, 郭子健, 戴赛民. 胰十二指肠切除术后胰瘘伴出血的处理[J]. 中华普外科手术学杂志(电子版), 2022, 16(06): 707-708.
[8] 尹立阳, 郭书华, 石媛媛, 张欣, 秦瑞锋, 袁增江. 预测胰十二指肠切除术后切口疝发病风险列线图模型的建立[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 653-657.
[9] 李骞, 成凯, 李传富, 齐硕, 丁成明, 贺军, 陈国栋. ERAS背景下机器人与腹腔镜胰十二指肠切除术的对比分析[J]. 中华腔镜外科杂志(电子版), 2023, 16(02): 73-78.
[10] 王勤运, 许大彬, 张恩犁, 钱海, 赵之明. 完全脏器转位机器人胰十二指肠切除术一例[J]. 中华腔镜外科杂志(电子版), 2023, 16(01): 52-55.
[11] 潘冰, 吕少诚, 赵昕, 李立新, 郎韧, 贺强. 淋巴结清扫数目对远端胆管癌胰十二指肠切除手术疗效的影响[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 608-612.
[12] 刘虎, 崔昭扬, 乐羿, 杨豪, 张绍庚. 胰十二指肠切除术后胰管支架管致肝脓肿一例并文献复习[J]. 中华肝脏外科手术学电子杂志, 2023, 12(04): 444-448.
[13] 李扬, 史亚波, 涂建华, 黄长文. 胰十二指肠切除术后胰瘘发生的危险因素及预防[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 352-355.
[14] 李杰, 任加强, 马坚, 王铮, 马清涌, 仵正. 血栓弹力图测定对远端胆管癌胰十二指肠切除术后出血的预测价值[J]. 中华肝脏外科手术学电子杂志, 2023, 12(02): 211-215.
[15] 饶雪峰, 黄长文, 龚帅昌, 殷俊翔, 曹振军. 腹腔镜胰十二指肠切除术胰管支架分离式外引流[J]. 中华肝脏外科手术学电子杂志, 2023, 12(01): 121-121.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号