Acta Medica Medianae
IMMEDIATE AND DISTANT EFFECTS OF THE PANCREATIC DUCT
OCCLUSION BY THE FIBRIN ADHESIVE
Miroslav Stojanović, Milan Jovanović, Goran Stanojević, Dragojlo Gmijović, Miroslav Jeremić, Miroslav Stojiljković, Miomir Pesić, Milan Višnjić, Zoran Stanojković, Vojin Savić, Vidosava Đorđević and Miloš Kostov
Surgical Clinic of the Clinic Center, Nis
The paper represent an experimental study the aim of which was to determine immediate consequences of the pancreatic duct occlusion by the fibrin adhesive upon the pancreas parenchyma as well as distant negative effects upon the exocrine and endocrine pancreatic secretion.
The experiment was carried out on the dogs divided into two groups of twenty animals, namely, into the experimental group of those animals that were subdued to the pancreas resection with the PJA formation and the anastomosis protection by means of the pancreatic duct occlusion with the fibrin adhesive (Tissucol - Immuno AG) and the control group that was, under the same conditions, subdued to the pancreas resection and the PJA with no anastomosis protection. In the post-operative course the animals are monitored for five months and during that time they were subjected to the clinic, biochemical, patho-histological, histochemical, immunocyte-chemical and scanning electronic-microscopic examination.
The fibrin cork lyse was noticed since the fifth post-operative day while it was fully completed on the thirteenth post-operative day. The statistical analysis of the biochemical parameters as well as pathohistological and scanmng-electronic exami-nations have revealed the signs ofeasier, subclinic forms ofedematose pancreatitis with a shortterm increase of the amylase level. The examinations after 150 days have shown the preserved morphology and the functional mtegrity ofthe exocrine and endocrine pancreas.
The authors conclude that the fibrin adhesive application in preventing the loosening up of the pancreaticjejuna anastomosis represents a simple and efficient procedure with no negative effects upon the exocrme and endocrine function and the pancreas morphology.
Key words: Pancreatic duct, prevention, pancreas fistula, fibrin adhesive, immediate and distant effects