Kim EY, Hong TH. Focal change of the pancreatic texture using a direct injection mixture of N-butyl cyanoacrylate and lipiodol in the pig model: a strategy for preventing pancreatic leakage during pancreatic surgery.
Ann Surg Treat Res 2018;
95:175-182. [PMID:
30310800 PMCID:
PMC6172351 DOI:
10.4174/astr.2018.95.4.175]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/25/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose
A soft texture of the pancreas is one of the most important predisposing factors for a pancreatic fistula. Thus, in a porcine model, we investigated a method to harden the pancreas locally by directly injecting an artificial material.
Methods
During the laparotomy, 51 samples from 17 pigs, including 13 survival models, were randomly divided into 3 groups and either received a direct injection into the pancreas of MHL (1:4 mixture of histoacryl [n-butyl cyanoacrylate] and lipiodol) (group E) or saline (group C) or only received a pinprick into the pancreas without injecting a substance (sham). We measured the change in the pancreatic hardness after the injection using a durometer and examined the histological change of the pancreas using the fibrosis grade in the survival model.
Results
The postinjection hardness of the pancreas was significantly increased in group E compared to group C and the sham group (P < 0.001). Pathologically, all cases in group E showed a severe fibrotic change, whereas the other groups demonstrated mild to no fibrosis (P < 0.001). The fibrosis in group E was localized to the area of the injection, while the surrounding areas were preserved.
Conclusion
The direct injection of MHL could induce focal hardening and fibrotic changes in the pancreas of the porcine model.
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