Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, 06591 Seoul, Korea.
Hepatobiliary Pancreat Dis Int. 2018 Feb;17(1):81-85. doi: 10.1016/j.hbpd.2018.01.009. Epub 2018 Feb 2.
Postoperative pancreatic fistula (POPF) is more likely to occur in a soft pancreas compared to a hard pancreas in which fibrosis has progressed. There is almost no leakage at the anastomosis site or cut surface of a hard pancreas. The aim of this study was to induce localized fibrosis at the cut surface of the pancreas in a rat model.
Thirty-six rats were divided into three groups (group S: normal saline group; group E: ethanol group; and group O: octreotide group). Each rat was directly injected with a particular compound at the duodenal lobe of the pancreatic parenchyma. Each group was divided into three subgroups according to the time of post-injection sacrifice (1, 2, or 4 weeks). The hardness, suture holding capacity (SHC), and histological fibrosis grade of each pancreas were measured.
The hardness, SHC, and fibrosis grade of groups E and O were increased at week 1, with greater increases in group E (all P < 0.001). In a subgroup comparison, the hardness, SHC, and fibrosis grade of group E tended to decrease gradually over time, with no regular pattern evident in group O. A comparison between the injected site (duodenal lobe) and non-injected site (splenic lobe) of the pancreas revealed increases in the three parameters of group E only in the duodenal lobe, with increases in group O at both the duodenal and splenic lobes.
Parenchymal injection of ethanol and octreotide increased pancreatic fibrosis. Unlike octreotide, ethanol provoked localized fibrosis that was maintained over time. It is expected that ethanol injection could eliminate POPF during pancreatic surgery.
与纤维化进展的硬胰腺相比，软胰腺更容易发生术后胰腺瘘（POPF）。硬胰腺的吻合口或切面几乎没有漏出。本研究旨在诱导大鼠模型胰腺切面的局部纤维化。
36 只大鼠分为三组（S 组：生理盐水组；E 组：乙醇组；O 组：奥曲肽组）。每只大鼠在胰实质十二指肠叶直接注射特定化合物。根据注射后处死时间（1、2 或 4 周），每组分为三个亚组。测量每个胰腺的硬度、缝线保持能力（SHC）和组织学纤维化程度。
E 组和 O 组在第 1 周时硬度、SHC 和纤维化程度增加，E 组增加更明显（均 P<0.001）。亚组比较显示，E 组硬度、SHC 和纤维化程度随时间逐渐降低，但 O 组无明显规律。胰腺注射部位（十二指肠叶）和非注射部位（脾叶）的比较显示，E 组仅在十二指肠叶三个参数增加，O 组在十二指肠和脾叶均增加。
实质内注射乙醇和奥曲肽可增加胰腺纤维化。与奥曲肽不同，乙醇引起的局部纤维化可维持较长时间。预计乙醇注射可在胰腺手术中消除 POPF。
