Establishment of a Canine Training Model for Digestive Tract Reconstruction after Pancreaticoduodenectomy

Abstract

Purpose

Practical training models can be a viable and effective educational tool that allows surgeons to acquire specific surgical techniques or skills. However, a suitable animal training model for reconstruction after a pancreaticoduodenectomy (PD) has not yet been reported. Therefore, we explored the feasibility and safety of establishing an animal training model for digestive tract reconstruction after a simulated PD using mongrel dogs.

Methods

We used the anatomical similarity between the canine and human digestive tract to simulate the digestive tract reconstruction after pancreatoduodenectomy. A hepatobiliary surgeon performed simulated PD digestive reconstructions on 6 mongrel canines. Pancreaticojejunostomy (PJ), biliary-enteric anastomosis (BEA), and jejuno-jejunal anastomosis (JJ) were performed sequentially. The survival rate, surgical operation time, complications, body weight changes, gross specimen, and pathological examination of the anastomotic region were observed 30 days after surgery.

Results

The survival rate 30 days after surgery was 100%. Total mean operative time was 230.5 ± 39.7 min. The operative time for PJ, BEA, and JJ was calculated as 21.5 ± 7 min, 21.7 ± 8.7 min, and 13.2 ± 1.8 min, respectively. An incision infection occurred in 1 case (16.7%); there was 1 case of ascites (16.7%), and 1 case of vomiting (16.7%). The total protein and total bilirubin indicators of the 6 dogs and the serum amylase index of 5 dogs 30 days postoperatively were within the normal range. The 6th dog’s serum amylase was approximately double the normal value, possibly due to pancreatitis. Observing the gross specimen, the mucosa of the anastomosis was intact and smooth. Masson staining showed that the bile duct and jejunum anastomosis, the pancreas, and jejunum of the 6 canines were all integrated with rich collagen.

Conclusion

Establishing an animal model for digestive tract reconstruction after a simulated PD in canines is feasible and safe.

Keywords:

• pancreaticoduodenectomy
• digestive tract reconstruction
• animal model
• canine
• anastomosis

Acknowledgements

We would like to gratefully acknowledge the contributions from the colleagues of the Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, P.R. China.

Funding

This work was supported by the Natural Science Foundation of Inner Mongolia under Grant [2017MS08354]; The Science and Technology Plan Project of Inner Mongolia under Grant [Year 2017]; Major scientific research project of Affiliated hospital of Inner Mongolia Medical University under Grant [NYFY ZD 003]; The Grassland Talents Program of the Inner Mongolia Autonomous Region; The Grassland Talents Innovative Group Programs of the Inner Mongolia Autonomous Region; The Project of Education Teaching Reform of the Inner Mongolia Medical University in 2018 under Grant [NYJXGG2018011]; The New Talent Project of the Inner Mongolia Medical University under Grant [NYJTXX201812]; Inner Mongolia Autonomous Region Education Department Graduate Education Teaching Reform Research and Practice Project under Grant [YJG20181013202]; and Inner Mongolia Medical University Teaching Team Project under Grant [NYJXTD201901].

Declaration of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.