Development of new surgical materials preventing tissue damages caused by pancreatic juice leakage

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K08681
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Osaka Metropolitan University (2022-2023); The University of Tokyo (2021)
• Principal Investigator: Ishizawa Takeaki 大阪公立大学, 大学院医学研究科, 教授 (10422312)
• Co-Investigator(Kenkyū-buntansha): 伊藤 大知 東京大学, 大学院医学系研究科(医学部), 教授 (50447421) ; 長谷川 潔 東京大学, 医学部附属病院, 教授 (20292906) ; 長田 梨比人 埼玉医科大学, 医学部附属病院, 助教 (00815706)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 膵液漏 / 消化酵素 / 手術合併症 / 膵切除 / 医療材料

Outline of Final Research Achievements

First, fluid samples obtained from patients after pancreatic resections were applied to the swine carotid artery. As a result, highest histological damages on the arterial wall were observed when patients' pancreatic juice was applied with intestinal fluid. Second, digestive enzyme solutions were applied onto the carotid artery. Then, trypsin and chymotrypsin were associated with thinning of the media, and trypsin and elastase affected on nuclear degeneration. Finally, mixture of patients' pancreatic juice and intestinal fluid was applied to the carotid artery after adding trypsin inhibitor, leading to prevention of tissue damages. In subsequent studies, we will create high polymer compound enabling sustained release of trypsin inhibitor to be placed on the vessel surfaces during pancreatic surgery.

Free Research Field

肝胆膵外科

Academic Significance and Societal Importance of the Research Achievements

手術後に膵液漏が起きると、組織障害により血管が破綻し致死的な出血が起こる。本研究は、膵液が腸液と混合して活性化したtrypsinが、動脈の中膜を菲薄化させ、平滑筋の核を変性させるというメカニズムを解明した。Trypsinの阻害剤を添加すると血管障害が回避されるため、阻害剤を徐放する医療材料で手術中に血管壁を被覆すれば、膵液漏に伴う出血を予防でき、手術の安全性が大幅に向上する可能性がある。