title: Decreasing pancreatic leak after distal pancreatectomy: bovine pericardium wrapping stump in a porcine model.
abstract: BACKGROUND
  Despite marked improvements in pancreatic surgery, the high incidence and morbidity of pancreatic leak after resection has remained unchanged. The current study investigated the safety and efficacy of bovine pericardium wrapping stump after distal pancreatectomy in a porcine model.
  
  
  METHODS
  Thirty-two swine were randomly assigned to control and experiment groups to undergo conventional scalpel transection with single hand-sewn closure of the pancreatic remnant (control) or bovine pericardium wrapping stump combined with hand-sewn closure (experiment). Closed-suction drainage was collected and measured daily. Animals were necropsied at 3 weeks postoperatively, and the pancreatic remnants were examined for histology. Primary end points were the development of a pancreatic fistula defined as greater than threefold drain/serum amylase after the 3rd postoperative day, and the presence of undrained amylase-rich fluid collections/abscess.
  
  
  RESULTS
  The incidence of pancreatic leak in the wrapping group was 6.3 versus 46.7% in the control group (p < 0.05). The amount of drainage ﬂuid was higher in the control group than the experiment group during the postoperative days. There were no differences in operative time or other clinical parameters measured. No other signiﬁcant differences were found in macroscopic changes between groups at reexploration. Histological examination demonstrated focal, chronic inﬂammation with necrosis in all animals.
  
  
  CONCLUSIONS
  Bovine pericardium wrapping stump effectively reduced the incidence of pancreatic leakage after the distal pancreatectomy.
authors.affiliation: Departments of General Surgery, The Sixth People's Hospital of Shanghai Jiaotong University, Shanghai, China. huangxinyush@hotmail.com
authors.forename: Xin-yu
authors.initials: XY
authors.lastname: Huang
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Yong-zhi
authors.initials: YZ
authors.lastname: Liu
authors.forename: Jia-zhe
authors.initials: JZ
authors.lastname: Liu
authors.forename: Hong-cheng
authors.initials: HC
authors.lastname: Wang
authors.forename: Qiong
authors.initials: Q
authors.lastname: Jiao
authors.forename: Zhou
authors.initials: Z
authors.lastname: Yuan
authors.forename: Kai-xing
authors.initials: KX
authors.lastname: Ai
authors.forename: Qi
authors.initials: Q
authors.lastname: Zheng
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D002417:Cattle; D010180:Pancreatectomy / Q000295:instrumentation / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D010496:Pericardium; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D013396:Suction; D034421:Sus scrofa; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials