Karaman Kerem, Bal Ali, Aziret Mehmet, Ercan Metin, Bostanci Erdal Birol, Akoglu Musa
a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
J Invest Surg. 2017 Aug;30(4):277-284. doi: 10.1080/08941939.2016.1240271. Epub 2016 Oct 26.
Which suture material is optimal for pancreaticojejunostomy (PJ) anastomosis is a matter of debate with contradictory results. The aim of the present in vitro study was to determine the effects of pancreatic juice, bile, and their mixture on different suture materials in terms of breaking strength and disintegration.
Four suture materials, silk, polyglactin 910, polydioxanone, and polypropylene, were tested in pancreatic juice, bile, and their mixture. Determination of breaking strength and disintegration under electron microscope for each suture material was done on days 0, 3, 6, and 10.
The breaking strength of polyglactin 910 and silk was significantly higher than polypropylene and polydioxanone (p < .05). Polyglactin 910 significantly lost its breaking strength with time in pancreatic juice, bile, and their mixture (p < .001). The breaking strength of each type of suture did not significantly alter in pancreatic juice, bile, and their mixture at the baseline measurement and at the end of the experiment (p > .05). No obvious disintegration has been observed under electron microscope in the architecture and appearance of suture materials after days of exposure to pancreatic juice, bile, and their mixture.
None of the suture materials was disintegrated on exposure to pancreatic juice, bile, and their mixture. Polyglactin 910 has the highest breaking strength and significantly loses its strength throughout the experiment but still remains higher than other suture materials. Polypropylene, polydioxanone, and silk showed less variation across the incubation period.
哪种缝合材料最适合胰空肠吻合术（PJ）存在争议，结果相互矛盾。本体外研究的目的是确定胰液、胆汁及其混合物对不同缝合材料的断裂强度和分解的影响。
对丝线、聚乙醇酸910、聚二氧六环酮和聚丙烯四种缝合材料在胰液、胆汁及其混合物中进行测试。在第0、3、6和10天对每种缝合材料进行断裂强度测定，并在电子显微镜下观察分解情况。
聚乙醇酸910和丝线的断裂强度显著高于聚丙烯和聚二氧六环酮（p <.05）。聚乙醇酸910在胰液、胆汁及其混合物中随时间显著降低其断裂强度（p <.001）。在基线测量和实验结束时，每种缝合材料在胰液、胆汁及其混合物中的断裂强度均无显著变化（p >.05）。在电子显微镜下，暴露于胰液、胆汁及其混合物数天后，缝合材料的结构和外观未观察到明显分解。
没有一种缝合材料在暴露于胰液、胆汁及其混合物时会分解。聚乙醇酸910具有最高的断裂强度，并且在整个实验过程中显著降低其强度，但仍高于其他缝合材料。聚丙烯、聚二氧六环酮和丝线在孵育期内变化较小。
