Background
Several reconstructive surgical techniques have been proposed for restoring pancreatico-jejunal
continuity. Little has been done, however, to evaluate the efficacy of tissue engineering
on anastomotic healing. We examined the effects of basic fibroblast growth factor
(bFGF) incorporated in gelatin hydrogel (GH) microspheres on the anastomotic healing
of pancreaticojejunostomy.
Methods
As a preliminary experiment, 20 female Wistar rats received a jejunal subserosal injection
of 1 μg of bFGF-GH (n = 10), 1 μg of Free-bFGF (n = 5), or gelatin alone (n = 5) to
study the effects of bFGF on the histology of normal jejunum on day 7 after the injection.
Next, 12 beagle dogs received a jejunal subserosal injection of 100-μg bFGF-GH (n
= 7) or gelatin alone (n = 5) at the anastomotic site of pancreaticojejunostomy. Four
types of assessment were performed to compare the 2 groups: pancreatography, breaking
strength test, pathologic examination, and calculation of the microvessel density
(MVD).
Results
The bFGF-GH injection led to markedly increased levels of collagen and fibroblastic
cellularity in the subserosal layer of the Wistar rats. In contrast, the rats treated
by gelatin alone exhibited no such effects. No anastomotic failures were observed
in the dogs treated by bFGF-GH. Histologic observations of this group revealed abundant
granulation tissues. Treatment with bFGF-GH significantly increased the breaking strength
and MVD over the levels measured in the control group (P < .01).
Conclusions
bFGF-GH accelerates healing of pancreaticojejunal anastomosis during the early postoperative
period. Basic FGF-GH may show promise as a new technique for preventing anastomotic
failure of pancreaticojejunostomy.
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Article info
Publication history
Accepted:
March 31,
2007
Footnotes
Supported by a grant-in-aid from the Japan Society for the Study of Surgical Techniques. The recombinant bFGF was provided by Kaken Pharmaceutical Co., Ltd., Tokyo, Japan, and the J-VAC drainage system was supplied by Johnson & Johnson Co., Tokyo, Japan.
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
