Xiang Fu, Yao Chenhui, Guan Guoxin, Luo Fuwen
The Second Affiliated Hospital of Dalian Medical University, Dalian 116021, China.
The First Affiliated Hospital of Dalian Medical University, Dalian 116021, China.
Bioengineering (Basel). 2024 Oct 8;11(10):1004. doi: 10.3390/bioengineering11101004.
Postoperative pancreatic fistula (POPF) is a common and challenging complication following pancreaticoduodenectomy (PD), occurring in 2% to 46% of cases. Despite various pancreaticojejunostomy techniques, an effective method to prevent POPF has not been established. This study aimed to develop and evaluate a novel 3D-printed biodegradable pancreatic duct stent to simplify the surgical process of pancreaticojejunostomy, reduce anastomotic complexity, and minimize postoperative complications. Data from 32 patients undergoing total laparoscopic pancreaticoduodenectomy were utilized. Preoperative CT scans were transformed into 3D reconstructions to guide the design and printing of customized stents using polylactic acid (PLA). The stents were assessed for mechanical integrity, surface texture, and thermal stability. Animal experiments were conducted on 16 mini pigs, with the experimental group receiving the novel stent and the control group receiving traditional silicone stents. The 3D-printed stents demonstrated accurate dimensional replication and mechanical reliability. In the animal experiments, the experimental group showed no significant difference in postoperative complications compared to the control group. At 4 weeks post-surgery, CT scans revealed well-healed anastomoses in both groups, with no significant inflammation or other complications. Histological examination and 3D reconstruction models confirmed good healing and device positioning in the experimental group. The 3D-printed biodegradable pancreatic duct stent offers a promising solution for pancreaticojejunostomy, with comparable safety and efficacy to traditional methods. Further research is needed to validate its clinical application.
术后胰瘘(POPF)是胰十二指肠切除术(PD)后常见且具有挑战性的并发症,发生率为2%至46%。尽管有多种胰肠吻合技术,但尚未建立有效的预防POPF的方法。本研究旨在开发和评估一种新型的3D打印可生物降解胰管支架,以简化胰肠吻合的手术过程,降低吻合复杂性,并将术后并发症降至最低。利用了32例行全腹腔镜胰十二指肠切除术患者的数据。术前CT扫描被转化为3D重建,以指导使用聚乳酸(PLA)定制支架的设计和打印。对支架的机械完整性、表面纹理和热稳定性进行了评估。对16只小型猪进行了动物实验,实验组接受新型支架,对照组接受传统硅胶支架。3D打印支架显示出精确的尺寸复制和机械可靠性。在动物实验中,实验组与对照组相比术后并发症无显著差异。术后4周,CT扫描显示两组吻合口愈合良好,无明显炎症或其他并发症。组织学检查和3D重建模型证实实验组愈合良好且装置定位良好。3D打印可生物降解胰管支架为胰肠吻合提供了一种有前景的解决方案,其安全性和有效性与传统方法相当。需要进一步研究以验证其临床应用。