A simple taurocholate-induced model of severe acute pancreatitis in rats

AIM: To investigate gut barrier damage and intestinal bacteria translocation in severe acute pancreatitis (SAP), a simple rat model of SAP was induced and studied.METHODS: Pancreatitis was induced by uniformly distributed injection of 3.8% Na taurocholate (1 mL/kg) beneath the pancreatic capsule. Rats in the control group were injected with normal saline in the identical location. RESULTS: Serum amylase, plasma endotoxin, intestinal permeability, and pancreatitis pathology scores were all markedly higher in the pancreatitis group than in the control group (P < 0.01). The bacterial infection rate was signif icantly higher in the SAP group than in the control group (P < 0.01), observed in parallel by both bacterial culture and real-time polymerase chain reaction. Acute damage of the pancreas was observed histologically in SAP rats, showing interstitial edema, leukocyte infiltration, acinar cell necrosis and hemorrhage. The microstructure of the intestinal mucosa of SAP ratsappeared to be destroyed with loose, shortened microvilli and rupture of the intercellular junction, as shown by electron microscopy. CONCLUSION: Significant gut barrier damage and intestinal bacterial translocation were def initely observed with few potential study confounders in this SAP rat model, suggesting that it may be an appropriate animal model for study of gut barrier damage and bacterial translocation in SAP.

Feasibility and efficacy of laparoscopic radical right hemicolectomy with complete mesocolic excision using an‘artery-first’approach

Background:According to previous guidelines,the lymph nodes around the right side of the superior mesenteric artery(SMA)should be dissected and removed en bloc.However,due to the technical challenge and the risk of complications,most surgeons perform the dissection along the axis of the superior mesenteric vein(SMV).Herein,we described an‘artery-first’approach for laparoscopic radical extended right hemicolectomy with complete mesocolic excision(CME).Methods:A total of 22 cases were collected from January to October 2016.The right side of the SMA and SMV were exposed and separated,and the No.203,No.213 and No.223 lymph nodes were dissected en bloc.Toldt’s fascia was dissected and expanded laterally to the ascending colon,cranial to the pancreas head.The caudal root of the mesentery and lateral attachments of the ascending colon were completely mobilized.Results:There were 9 male and 13 female patients,with a mean age of 63.1(range,39–83)years and the mean body mass index was 24.6(range,18.3–37.7)kg/m^(2).The mean operative time was 192.5(range,145–240)minutes and the mean intraoperative blood loss was 55.0(range,10–300)ml.The mean number of harvested lymph nodes was 27.0(range,13–55)and the time to flatus and hospital stay were 35.0(range,26–120)hours and 7.5(range,5–20)days,respectively.Minor complications occurred in two patients and no post-operative death was observed.Conclusions:The preliminary results suggest that the reported approach may be a feasible and safe procedure that is more in accordance with the principles of CME.