Triple-drug therapy to prevent pancreatic fistula after pancreatectomy in a rat model

Abstract

BackgroundPancreatic fistula (PF) is one of post-operative complications in pancreatic surgery, but there is no consensus about the optimal treatment for PF. Our group has established a rat model of PF, and we conducted the present investigation to determine the efficacy of the triple-drug therapy (somatostatin analogue, gabexate mesilate, and imipenem/cilastatin) against PF using our rat model. MethodsIn the PF rat model, the triple-drug therapy was administered to the treated (T) group (n = 4), and we compared the results with those of a control (C) group (n = 4). The rats were sacrificed on postoperative day 3 (POD 3) and the levels of amylase and lipase in serum and ascites were measured. The intra-abdominal adhesion was scored. Each pancreas was evaluated pathologically, and inflammation was scored. ResultsThe ascitic amylase levels on POD 3 were 1982 (1738–2249) IU/L in the C group and significantly lower at 136 (101–198) IU/L in the T group (p = 0.02). The ascitic lipase levels on POD 3 were 406 (265–478) U/L in the C group and significantly lower at 13 (7–17) U/L in the T group (p = 0.02). The intra-abdominal adhesion score on POD 3 was 2 (1–2) in the C group and significantly lower at 0 (0–1) in the T group (p = 0.02). The histological evaluation showed that the average of pancreatic inflammatory score was 8.5 (8–9) in the C group and significantly milder at 5 (5–7) in the T group (p = 0.01). ConclusionOur findings suggest that the triple-drug therapy could be useful as a treatment for PF in clinical settings.