Non-woven PGA fabrics for the treatment of pancreatic juice leakage : a preliminary report

We developed sheets of non-woven poly (glycolic acid) PGA fabric that can act as a scaffold to form smoothly dense granulation tissue for barrier walls to localize leakage of pancreatic juice. In this study, we tested three kinds of materials: poly (Llactide-e-caprolactone) (copolymer) film, PGA fabric-0.9 with a mean fiber diameter of 0.9μm and PGA fabric-20 with a mean fiber diameter of 20 μm. Under general anesthesia, the pancreatic surface of rats was cauterized with an electric scalpel. Then, the pancreas was wrapped with one of the three kinds of sheets and the sheet was fixed onto the surrounding tissues. Survival was observed for five days after surgery. The survival rates were higher in the two groups of fabric-treated rats than in the other groups, although the differences were significant only for the film-treated group. Macroscopically, severe pathologic findings such as accumulation of ascites, tumor formation in whole intraperitoneal organs and generalized peritonitis occurred at a significantly lower incidence in the two fabric-treated groups than in the film-treated group. Microscopically, granulation tissue was formed along the fabrics throughout the full thickness of the fabric scaffolds of fabric-0.9 and fabric-20. In these groups, injurious tissue changes and inflammatory reactions were reduced in the outer zone of the fabric wall compared to that observed in the inner zone. Therefore, the new PGA fabrics successfully localized pancreatic juice leakage. In contrast, in the no treatment group and the film-treated group, injurious tissue changes and severe inflammation were spread out to places distant from the cauterized pancreas. In the film-treated group in particular, the accumulation of mono nuclear inflammatory cells was spread along the film, even into the outer zone of the sheet, and granulation formation of a barrier wall was suppressed around the film. Therefore, in the film-treated group, tissue injury and inflammation caused by pancreatic juice extended more widely and granulation formation of a barrier wall was strongly suppressed, even compared with that observed in the no treatment group. In conclusion, these fabrics can be a more suitable and effective material for the treatment of leakage of pancreatic juice.