title: Triple-drug therapy to prevent pancreatic fistula after pancreatectomy in a rat model.
abstract: BACKGROUND
  Pancreatic fistula (PF) is one of post-operative complications in pancreatic surgery, but there is no consensus about the optimal treatment for PF. Our group has established a rat model of PF, and we conducted the present investigation to determine the efficacy of the triple-drug therapy (somatostatin analogue, gabexate mesilate, and imipenem/cilastatin) against PF using our rat model.
  
  
  METHODS
  In the PF rat model, the triple-drug therapy was administered to the treated (T) group (n = 4), and we compared the results with those of a control (C) group (n = 4). The rats were sacrificed on postoperative day 3 (POD 3) and the levels of amylase and lipase in serum and ascites were measured. The intra-abdominal adhesion was scored. Each pancreas was evaluated pathologically, and inflammation was scored.
  
  
  RESULTS
  The ascitic amylase levels on POD 3 were 1982 (1738-2249) IU/L in the C group and significantly lower at 136 (101-198) IU/L in the T group (p = 0.02). The ascitic lipase levels on POD 3 were 406 (265-478) U/L in the C group and significantly lower at 13 (7-17) U/L in the T group (p = 0.02). The intra-abdominal adhesion score on POD 3 was 2 (1-2) in the C group and significantly lower at 0 (0-1) in the T group (p = 0.02). The histological evaluation showed that the average of pancreatic inflammatory score was 8.5 (8-9) in the C group and significantly milder at 5 (5-7) in the T group (p = 0.01).
  
  
  CONCLUSIONS
  Our findings suggest that the triple-drug therapy could be useful as a treatment for PF in clinical settings.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kuroshima
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Amane
authors.initials: A
authors.lastname: Kitasato
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Adachi
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsushima
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Hirayama
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: sueguchi@nagasaki-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D000681:Amylases / Q000097:blood / Q000378:metabolism; D000818:Animals; D001201:Ascites / Q000201:enzymology; D015377:Cilastatin / Q000627:therapeutic use*; D016670:Gabexate / Q000627:therapeutic use*; D015378:Imipenem / Q000627:therapeutic use*; D008049:Lipase / Q000097:blood / Q000378:metabolism; D008297:Male; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D051381:Rats; D011916:Rats, Inbred F344; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
chemical_list: D015842:Serine Proteinase Inhibitors; D015377:Cilastatin; D016670:Gabexate; D013004:Somatostatin; D015378:Imipenem; D008049:Lipase; D000681:Amylases
keywords: Antibiotic; Complication; Gabexate mesilate; Pancreatic fistula; Somatostatin analogue