New polyglycolic acid fabric for the prevention of postoperative pancreatic fistulas

Toshitaka Takagi, Hiroyuki Tsujimoto, Hiroko Torii, Yuki Ozamoto, Akeo Hagiwara
2018 Asian Journal of Surgery  
KEYWORDS distal pancreatectomy; pancreatic surgery; polyglycolic acid; postoperative pancreatic fistula; scaffold Summary Background: The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy is approximately 30%. The most serious complications of pancreatic resection, such as mortality and prolonged hospitalization, are unresolved despite the proposal of various surgical procedures. We developed a new polyglycolic acid (PGA) fabric composed of fine diameter fibers to
more » ... prevent POPF, and macroscopically and microscopically evaluated the effects of applying it to the pancreatic remnant. Methods: The ventral pancreatic surface was cauterized to create the experimental model of POPF in 33 female Wistar/ST rats. The injured sites were wrapped with nonwoven PGA fabrics of different fiber diameters and porosities in the treated rats; one group of rats remained untreated. Survival, incidence of generalized peritonitis, and microscopic findings around the pancreas were investigated. Results: The PGA fabrics acted as a scaffold for tissue repair and resulted in superior survival. Generalized peritonitis was milder in the PGA treated groups. With the new PGA fabric, abundant fibroblast infiltration and a uniformly-developed, self-organized barrier wall prevented both pancreatic leak and spread of inflammation.
doi:10.1016/j.asjsur.2016.08.001 pmid:27649862 fatcat:ecus2dwb5nftzphcl5fcvztw6e