title: New polyglycolic acid fabric for the prevention of postoperative pancreatic fistulas.
abstract: BACKGROUND
  The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy is approximately 30%. The most serious complications of pancreatic resection, such as mortality and prolonged hospitalization, are unresolved despite the proposal of various surgical procedures. We developed a new polyglycolic acid (PGA) fabric composed of fine diameter fibers to prevent POPF, and macroscopically and microscopically evaluated the effects of applying it to the pancreatic remnant.
  
  
  METHODS
  The ventral pancreatic surface was cauterized to create the experimental model of POPF in 33 female Wistar/ST rats. The injured sites were wrapped with nonwoven PGA fabrics of different fiber diameters and porosities in the treated rats; one group of rats remained untreated. Survival, incidence of generalized peritonitis, and microscopic findings around the pancreas were investigated.
  
  
  RESULTS
  The PGA fabrics acted as a scaffold for tissue repair and resulted in superior survival. Generalized peritonitis was milder in the PGA treated groups. With the new PGA fabric, abundant fibroblast infiltration and a uniformly-developed, self-organized barrier wall prevented both pancreatic leak and spread of inflammation.
  
  
  CONCLUSIONS
  Application of the newly developed PGA fabric to the pancreatic remnant prevented POPF, and the essential factor for preventing pancreatic leak was the early formation of a self-organized barrier.
authors.affiliation: Department of Medical Life System, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, Japan; Dai-Ichi Okamoto Hospital, 9-50 Kyo-Machi, Hushimi, Kyoto, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Medical Life System, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsujimoto
authors.affiliation: Department of Medical Life System, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, Japan; Department of the 2nd Surgery, Kusatsu General Hospital, 1660 Yabashi, Kusatsu, Shiga, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Torii
authors.affiliation: Department of Medical Life System, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, Japan; Department of the 2nd Surgery, Kusatsu General Hospital, 1660 Yabashi, Kusatsu, Shiga, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ozamoto
authors.affiliation: Department of Medical Life System, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, Japan. Electronic address: marina.1108@zeus.eonet.ne.jp.
authors.forename: Akeo
authors.initials: A
authors.lastname: Hagiwara
mesh_terms: D000818:Animals; D005260:Female; D048091:Guided Tissue Regeneration / Q000379:methods*; D010180:Pancreatectomy; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D011100:Polyglycolic Acid
keywords: distal pancreatectomy; pancreatic surgery; polyglycolic acid; postoperative pancreatic fistula; scaffold