Department of Surgery and Oncology, General and Pancreatic Surgery - The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
Department of Computer Science, University of Verona, Verona, Italy.
J Gastrointest Surg. 2018 Mar;22(3):444-450. doi: 10.1007/s11605-017-3558-z. Epub 2017 Aug 31.
The impact of suture materials on the development of pancreatic fistula after pancreaticoduodenectomy remains unclear. Thus, their choice among pancreatic surgeons is still mostly experience-based. Aim of the present study is to assess what is the best suture material to be used for pancreaticojejunostomy.
The force needed to reach the breaking point of five widely used suture materials (polypropylene, polyester, polydioxanone, silk, and polyglactin 910) has been determined through a digital precision dynamometer at baseline and after 5 and 20 days of incubation in pancreatic juice, bile, or a mixture of both.
Regardless of the condition, polyglactin 910 has retained only 10% of its baseline force. Silk has maintained almost 90% of its initial force showing a very low baseline value of force. In pancreatic juice, polypropylene has lost less force compared to polyester (0.25 vs. 0.93 N; p = 0.03) and polydioxanone (0.25 vs. 3.67 N; p = 0.04). Polyester and polydioxanone have showed similar values of force. However, polydioxanone has lost a significant amount of force in pancreatic juice when compared to polyester (0.93 vs. 3.67 N; p = 0.03). Polyester has showed the highest value of force needed to reach the breaking point after 20 days of incubation in pancreatic juice.
After incubation in pancreaticobiliary secretions, polyglactin 910 loses almost all its force. Polypropylene preserves its characteristic, but polydioxanone and polyester show absolute higher breaking points, with polyester retaining the highest value of force needed to reach its breaking point after incubation in pancreatic juice.
缝合材料对胰十二指肠切除术后胰瘘发展的影响尚不清楚。因此，胰腺外科医生对其选择仍主要基于经验。本研究旨在评估用于胰肠吻合术的最佳缝合材料。
通过数字精密测力计，在基线以及在胰液、胆汁或两者混合物中孵育 5 天和 20 天后，测定五种广泛使用的缝合材料（聚丙烯、聚酯、聚二氧六环酮、丝和聚甘醇酸 910）达到断裂点所需的力。
无论在何种条件下，聚甘醇酸 910 仅保留了其基线力的 10%。丝线保持了近 90%的初始力，显示出非常低的基线力值。在胰液中，与聚酯（0.25 对 0.93N；p=0.03）和聚二氧六环酮（0.25 对 3.67N；p=0.04）相比，聚丙烯失去的力较少。聚酯和聚二氧六环酮表现出相似的力值。然而，与聚酯（0.93 对 3.67N；p=0.03）相比，聚二氧六环酮在胰液中失去了大量的力。聚酯在胰液孵育 20 天后达到断裂点所需的力值最高。
在胰胆分泌物孵育后，聚甘醇酸 910 几乎失去了所有的力。聚丙烯保持其特性，但聚二氧六环酮和聚酯显示出绝对更高的断裂点，聚酯在胰液孵育后保持达到断裂点所需的力值最高。
