A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture

Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable...

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Bibliographic Details
Published in:Scientific reports 2020-01, Vol.10 (1), p.1518-1518, Article 1518
Main Authors: Bakheet, Nader, Park, Jung-Hoon, Shin, Sang Hyun, Hong, Sarang, Park, Yejong, Shim, In Kyong, Hwang, Changmo, Jeon, Jae Yong, Lopera, Jorge E., Song, Ho-Young, Kim, Song Cheol
Format: Article
Language:English
Subjects:
631/67/1504/1713
639/166/985
692/308/2778
692/308/575
692/4020/1503/1712/1713
Absorbable Implants - veterinary
Anastomosis, Surgical - instrumentation
Anastomosis, Surgical - methods
Animals
Biodegradability
Biodegradation
Constriction, Pathologic - surgery
Diabetes mellitus
Disease Models, Animal
Duodenum
Humanities and Social Sciences
Implants
Male
Malnutrition
multidisciplinary
Pancreas
Pancreas - surgery
Pancreatic Ducts - surgery
Pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Pancreaticoduodenectomy - methods
Pancreaticojejunostomy
Postoperative Complications - surgery
Rats
Rats, Sprague-Dawley
Science
Science (multidisciplinary)
Stents
Stricture
Swine
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Summary:Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable tubular stent (BTS) for preventing a pancreaticojejunostomy (PJ) anastomotic stricture in both a rat and porcine model. The BTS was manufactured using a terpolymer comprising poly p-dioxanone, trimethylene carbonate, and glycolide. A cohort of 42 rats was randomized into 7 groups of 6 animals each after BTS placement into the duodenum for the biodegradation assay. A total of 12 pigs were randomized equally into a control and BTS placement group. The effectiveness of the BTS was assessed by comparing radiologic images with histologic results. Surgical procedures and/or BTS placements were technically successful in all animals. The median mass losses of the removed BTS samples from the rat duodenum were 2.1, 6.8, 11.2, 19.4, 26.1, and 56.8% at 1, 2, 3, 4, 6, and 8 weeks, respectively. The BTS had completely degraded at 12 weeks in the rats. In the porcine PJ model, the mean luminal diameter and area of the pancreatic duct in the control group was significantly larger than in the BTS group (all p  
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-57271-4