| objective:By analyzing the preliminary experimental results of mucosal preferential pancreatic duct jejunostomy,animal models were established for further experiments,experimental conditions were explored,and the scientific and feasibility of experimental design was tested.Methods:Six healthy female beagles(age:1 year old)were selected.Weight:8kg-10kg,average:8.62kg.There were 3 patients in the experimental group and 3 patients in the control group.The patients in the experimental group received the modified pancreatic duct jejunostomy under the guidance of the theory of mucosal preferential healing,and the patients in the control group received the classic end-to-side entraped-pancreatic jejunostomy.The survival conditions,general conditions,biochemical indexes and postoperative anastomotic histopathologic changes of beagle dogs were detected during perioperative period(pre-operation,1,6,14 and 21 days after operation).Results:(1)Living conditions:In the indoor ventilated environment,the appropriate temperature is 18℃-25℃,and the relative humidity is 40%-60%.(2)General information:the median preoperative weight was 9.34kg in the experimental group and 9.05kg in the control group.The median postoperative body weight was 9.03kg in the experimental group,0.31kg compared to the preoperative weight loss,and 8.63kg in the control group,0.42kg compared to the preoperative weight loss.Texture of pancreas.During the operation,it was observed that the pancreases of dogs in both groups were pink,slender and mostly V-shaped,with soft texture.The postoperative mortality rate was 0 in the experimental group and 33.3%in the control group.One dog in the control group died 11 days after the operation,and the autopsy revealed pancreaticojejunostomy fistula and infection,massive fluid accumulation in the abdominal cavity,and serious tissue necrosis.Pancreatoenteroanastomosis time was 29.3min in the experimental group and 19.2min in the control group on average,and the operation time in the experimental group was 10.1min longer than that in the control group.Intraoperative pancreatic duct diameter was 2.25mm in the experimental group and 2.16mm in the control group.(2)Biochemical indexes:preoperative blood glucose,4.76mmol/L in the experimental group and 5.14mmol/L in the control group;The median blood glucose of 4 times after surgery was 5.11mmol/L in the experimental group,1.10 times higher than the preoperative average blood glucose,and 5.72mmol/L in the control group,1.11 times higher than the preoperative average blood glucose.The average preoperative serum amylase was 657.30U/L in the experimental group and 658.2U/L in the control group.The median serum amylase of 4 times after operation was 1072.05U/L in the experimental group,1.63 times higher than the preoperative average serum amylase,and 1151.85U/L in the control group,1.75 times higher than the preoperative average.(3)In the experimental group of pancreaticojejunostomy under the pancreaticojejunal theory,the healing inflammation of pancreaticojej unostomy was light,the degree of edema was light,and the healing was relatively good.Classic end-to-side entraped-pancreaticojejunostomy in the control group:in the pancreaticoj ejunostomy group,the healing of the mouth was poor,the inflammatory reaction of the anastomosis was more serious,the edema of the pancreas and jejunum side was obvious,and the structure was disordered.Conclusion:1.The experimental conditions reached the expected level,the experimental scheme was designed reasonably,and the experimental process progressed smoothly.2.Mucosa preferentially healing of pancreatic duct jejunal anastomosis is performed in the outer layer as fibrous tissue healing,and the inner layer as mucosal connection healing.The inner layer is the crawling healing of intestinal mucosa from all sides to the center,which covers pancreatic tissue through the repair of intestinal mucosa itself,and finally completes the connection of intestinal mucosa and pancreatic duct mucosa to complete the healing.3.In terms of anastomosis technology,mucosal preferential pancreatic duct jejunostomy has a longer anastomotic time,but the anastomotic edema is light,the anastomotic patency is good,the structure is regular,the healing is good,and the pancreatic fistula is less.4.In this study,the pancreatic duct of pancreatic remnant was observed to have varying degrees of dilatation,which was related to intertissue healing,proliferation and crawling of fibrous tissue,and atrophy of glandular parenchyma,but the degree of dilatation in the experimental group was less than that in the control group.5.The establishment results of pre-experimental animal models meet expectations,and subsequent animal experiments can be carried out. |
