A new reconstructive procedure after segmental pancreatectomy: an experimental study of pancreatic end-to-end (duct-to-duct) anastomosis.
We produced experimental models of pancreatic end-to-end anastomosis, including ductal end-to-end anastomosis (with or without stent) and pancreaticojejunostomy, using mongrel dogs, with a view to evaluating reconstructive procedures after segmental pancreatectomy. We examined macroscopic findings, pancreatograms, and microangiographic and histopathological findings to determine whether pancreatic end-to-end anastomosis was as practicable as pancreaticojejunostomy. Macroscopic findings showed no suture failure in any animal in the end-to-end anastomosis group. Pancreatography revealed obstruction of the stent tube in the stent subgroup, but good patency in the no-stent subgroup. On the imaging of the microvasculature in the end-to-end anastomosis group, proliferation of neovascular vessels and formation of communicating vessels were detected. Histopathologically, no suture failure was detected, and the viability of the pancreatic end-to-end anastomosis was confirmed. From this experiment, we concluded it that it was possible to employ pancreatic end-to-end anastomosis after segmental pancreatectomy in the clinical situation.