Li Yuan, Yang Xiaofeng, Zhang Chuang, Zhou Lixia, Sun Chi, Li Suolin
Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, 215# Heping West Road, Shijiazhuang, Hebei Province, People's Republic of China.
Department of Pediatric Surgery, Xingtai People's Hospital, 16# Hongxing Street, Xingtai, Hebei Province, People's Republic of China.
Sci Rep. 2025 Jul 25;15(1):27150. doi: 10.1038/s41598-025-12652-w.
This study aims to compare the applied efficacy of barbed suture versus non-barbed suture, as well as various stitching techniques, for laparoscopic cholecystoduodenostomy (LCD) in rabbits (imitating infants) to determine the most viable suture option. LCD was performed in a total of 45 male New Zealand white rabbits. The rabbits were equally divided into three groups: the SFB group (single-layer full-thickness running suture using barbed sutures), the SSB group (simple seromuscular layer running suture using barbed sutures) and the PDS group (single-layer full-thickness running suture using PDS sutures). The incidence of anastomotic complications, and histopathological outcomes were evaluated and compared across the groups. The mean duration for LCD was 9.6 ± 1.2 min in the SFB group and 10.8 ± 1.5 min in SSB group, both significantly shorter than the 12.0 ± 0.9 min observed in the PDS group (P < 0.001). Three cases of bile leakage were found in SFB group. H&E staining clearly revealed two cases of ectopic mucosal tissues at the anastomotic muscular layer in the SFB group. The collagen fibers, transforming growth factor-beta1 (TGF-β1), α-smooth muscle actin (α-SMA) and interleukin 6 (IL-6) of anastomotic tissues at all examined time points post-surgery were generally higher in SFB group than in the other two groups, with some statistically significant differences. No significant differences were observed between the SSB group and PDS group. The findings demonstrate that for barbed sutures, full-thickness technique was inferior to PDS sutures due to a higher bile leakage rate, whereas the seromuscular technique achieved difficult to hepatic duct. As a result, barbed sutures are not recommended for use in infants.
本研究旨在比较倒刺缝线与非倒刺缝线以及各种缝合技术在兔（模拟婴儿）腹腔镜胆囊十二指肠吻合术（LCD）中的应用效果，以确定最可行的缝合选择。总共45只雄性新西兰白兔接受了LCD手术。这些兔子被平均分为三组：SFB组（使用倒刺缝线进行单层全层连续缝合）、SSB组（使用倒刺缝线进行简单浆肌层连续缝合）和PDS组（使用PDS缝线进行单层全层连续缝合）。评估并比较各组吻合口并发症的发生率和组织病理学结果。SFB组LCD的平均持续时间为9.6±1.2分钟，SSB组为10.8±1.5分钟，均显著短于PDS组观察到的12.0±0.9分钟（P<0.001）。SFB组发现3例胆漏。苏木精-伊红染色清楚地显示SFB组吻合肌层有2例异位黏膜组织。术后所有检查时间点吻合组织的胶原纤维、转化生长因子-β1（TGF-β1）、α-平滑肌肌动蛋白（α-SMA）和白细胞介素6（IL-6）在SFB组总体上高于其他两组，有一些统计学上的显著差异。SSB组和PDS组之间未观察到显著差异。研究结果表明，对于倒刺缝线，全层技术由于胆漏率较高而不如PDS缝线，而浆肌层技术难以应用于肝管。因此，不建议在婴儿中使用倒刺缝线。
