title: Novel pancreatoenteric reconstruction using a bioabsorbable polymer sheet and biocompatible bond.
abstract: BACKGROUND
  Pancreatoenteric reconstruction often induces severe complications. Although many techniques have been developed to prevent these complications, no standard technique has yet emerged. We developed a novel technique, sutureless pancreatoenteric anastomosis, that uses a bioabsorbable polymer sheet (BAPS) and biocompatible bond (BCB) to prevent the complications associated with pancreatoenteric anastomosis. We used large animals to investigate whether this technique is suitable for clinical use.
  
  
  METHODS
  Six pigs were laparotomized under general anesthesia. The body of the pancreas was divided, and the proximal stump was closed by suture. A BAPS coated with BCB was rolled and fixed around the distal pancreatic stump to form a cylinder that was anastomosed to the duodenum without suturing the pancreas. Twenty weeks after the initial operation the operated sites were extirpated and evaluated grossly and histologically.
  
  
  RESULTS
  All operated pigs survived without pancreatic juice leakage until they were killed. At 20 wk, the BAPS could not be identified. The pancreatic stump was tightly affixed to the duodenum. Histologic study revealed that the pancreatic stump and duodenal wall were continuous and the main pancreatic duct opened into the lumen of the duodenum.
  
  
  CONCLUSIONS
  Sutureless pancreatoenterostomy with BAPS and BCB may be clinically feasible.
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan. aikawa@saitama-med.ac.jp
authors.forename: Masayasu
authors.initials: M
authors.lastname: Aikawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Kojun
authors.initials: K
authors.lastname: Okamoto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Okada
authors.forename: Naoe
authors.initials: N
authors.lastname: Akimoto
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikada
mesh_terms: D020341:Absorbable Implants; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods*; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D004386:Duodenum / Q000601:surgery*; D005240:Feasibility Studies; D010179:Pancreas / Q000601:surgery*; D013552:Swine; D013718:Tensile Strength
chemical_list: D001672:Biocompatible Materials