Creation of an instrument for preventing postoperative pancreatic fistula

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17701
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Jichi Medical University
• Principal Investigator: Kaneda Yuji 自治医科大学, 医学部, 准教授 (00600868)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 膵液瘻 / 膵体尾部切除術 / 膵断端処置具 / 自動縫合器 / 生体吸収性ポリマー

Outline of Final Research Achievements

Pancreatic fistula after distal pancreatectomy is a severe complication that leads to death. However, there is still no effective method for closing the pancreatic stump. To reduce the incidence of pancreatic fistula, we have developed a new surgical device (bioabsorbable polymer) that enables closure of the pancreatic stump while preserving arterial blood flow without damaging the pancreatic tissue.
Closure of the pancreatic stump with the new device was confirmed to contribute to preventing pancreatic tissue necrosis in a porcine study. Furthermore, the pressure resistance is significantly higher than that of the stapler. It was also shown that the new device may have a preventive effect against pancreatic fistula at one week and one month after distal pancreatectomy. This study is expected to improve the safety of distal pancreatectomy.

Free Research Field

医療機器開発　肝胆膵外科

Academic Significance and Societal Importance of the Research Achievements

膵体尾部切除術における従来法(自動縫合器法、手縫い法、小腸パッチ法)の問題点は、(A)膵実質に針やステイプルが入るため、膵実質損傷、膵管損傷が避けられない、(B)膵断端への血流調整が不可能、の2点に集約される。膵断端処置具による膵断端閉鎖は、(a)針やステイプルを使用しないので、膵実質損傷、膵管損傷が起こらない、(b)結紮力の調整が可能なため、膵断端への動脈血流温存が可能、という特徴を有し、従来法に対して大きな優位性を持つ。本研究により、膵断端処置具が膵液瘻予防、膵壊死予防に寄与する可能性が示唆された。本研究は膵体尾部切除術の安全性向上、術後補助化学療法のスムーズな導入に繋がると期待できる。