两种缝线在模拟胰十二指肠切除术胆肠吻合重建动物实验中的应用

Animal experimental study of two sutures in reconstruction of biliary-enteric anastomosis after pancreatoduodenectomy

目的通过模拟胰十二指肠切除术胆肠吻合重建,寻找适宜的胆肠吻合术缝线。方法选择健康犬6只,随机分成Prolene组(使用prolene线缝合吻合口)和PDS组(使用PDS线缝合吻合口),每组3只。完成术前准备后行模拟胰十二指肠切除重建术,选择不同的吻合缝线,观察实验犬胆总管内壁直径及肝功能变化。结果2组实验犬术后生存率均为100%,感染率为33.3%。PDS组术中与术后30 d胆总管内壁直径比较,差异有统计学意义(P<0.05)。Prolene组术中与术后30 d胆总管内壁直径比较,差异无统计学意义(P>0.05)。2组术中胆总管内壁直径与术后30 d胆总管内壁直径差值、平均胆管扩张度比较,差异均无统计学意义(P>0.05)。2组术后发生恶心呕吐与肝功能异常并发症比较,差异无统计学意义(P>0.05)。2组术前、术后7 d、14 d、30 d的ALT、AST、TBIL、ALKP比较,差异均无统计学意义(P>0.05)。术后7 d,Prolene组的ALT、AST、TBIL、ALKP值最大。结论在早期预后方面,应用Prolene线缝合胆肠吻合口对吻合口的影响小于PDS线。

Objective To find the best suture material for reconstruction of biliary-enteric anastomosis after pancreatoduodenectomy.Methods Six healthy adult hybrid dogs were selected and randomly divided into Prolene group(sutured with prolene suture)and PDS group(sutured with PDS suture),3 dogs in each group.After preoperative preparation,a simulated pancreaticoduodenectomy was performed with different sutures to observe the diameter of the common bile duct and liver function.Results The survival rate of the two groups was 100%,and the infection rate was 33.3%.The diameter of the inner wall of the common bile duct in the experimental animals of the PDS group was significantly different from the diameter of the inner wall of the common bile duct in 30 days after operation,the difference was significant(P<0.05).There was no significant difference in postoperative nausea and vomiting and liver function abnormalities between the two groups,nor the diameter of the common bile duct wall in the Prolene group and that in the 30 days after surgery(P>0.05).There was no significant difference in the difference of the intra-operative diameter of the common bile duct wall,the diameter difference of intra-operation and post-operation of the common bile duct and the mean bile duct dilatation between the Prolene group and the PDS group(P>0.05).There was no significant differences in levels of ALT,AST,TBIL and ALKP between the Prolene group and the PDS group before surgery and 7 days,14 days,30 days after surgery(P>0.05).The levels of ALT,AST,TBIL and ALKP were the highest in the Prolene group at 7 days after surgery in the Prolene group,meanwhile the levels of ALT,AST,TBIL,and ALKP were smaller in the PDS group.Conclusion In terms of early prognosis,the effect of Prolene on the anastomosis of biliary-enteric anastomosis was less than that of PDS.