title: Which Suture Material is Optimal for Pancreaticojejunostomy Anastomosis? An In Vitro Study.
abstract: BACKGROUND
  Which suture material is optimal for pancreaticojejunostomy (PJ) anastomosis is a matter of debate with contradictory results. The aim of the present in vitro study was to determine the effects of pancreatic juice, bile, and their mixture on different suture materials in terms of breaking strength and disintegration.
  
  
  METHODS
  Four suture materials, silk, polyglactin 910, polydioxanone, and polypropylene, were tested in pancreatic juice, bile, and their mixture. Determination of breaking strength and disintegration under electron microscope for each suture material was done on days 0, 3, 6, and 10.
  
  
  RESULTS
  The breaking strength of polyglactin 910 and silk was significantly higher than polypropylene and polydioxanone (p < .05). Polyglactin 910 significantly lost its breaking strength with time in pancreatic juice, bile, and their mixture (p < .001). The breaking strength of each type of suture did not significantly alter in pancreatic juice, bile, and their mixture at the baseline measurement and at the end of the experiment (p > .05). No obvious disintegration has been observed under electron microscope in the architecture and appearance of suture materials after days of exposure to pancreatic juice, bile, and their mixture.
  
  
  CONCLUSIONS
  None of the suture materials was disintegrated on exposure to pancreatic juice, bile, and their mixture. Polyglactin 910 has the highest breaking strength and significantly loses its strength throughout the experiment but still remains higher than other suture materials. Polypropylene, polydioxanone, and silk showed less variation across the incubation period.
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Kerem
authors: K
authors: Karaman
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Ali
authors: A
authors: Bal
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Mehmet
authors: M
authors: Aziret
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Metin
authors: M
authors: Ercan
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Erdal Birol
authors: EB
authors: Bostanci
authors: a Department of Gastroenterological Surgery , Faculty of Medicine , Sakarya University , Sakarya , Turkey.
authors: Musa
authors: M
authors: Akoglu
mesh_terms: D010193:Pancreaticojejunostomy; D013537:Sutures
keywords: bile; breaking strength; disintegration; pancreatic juice; pancreaticojejunostomy anastomosis; suture