A comparison of ductal management techniques in an in situ canine pancreas model

Twenty-five dogs underwent right pancreatectomy leaving the tall of the pancreas in situ. Five equal groups underwent either intraperitoneal drainage (open-duct group), duct ligation, acrylate glue occlusion, neoprene glue occlusion, or Roux-en-Y pancreaticojejunostomy. On day 21 the tall of the pancreas was removed and on day 28 the dogs were killed. Daily serum glucose and amylase and biweekly insulin determinations were performed, and intravenous glucose tolerance tests ( IVGTTs ), with simultaneous insulin assays, were carried out before and after distal pancreatectomy. The mean daily blood glucose level prior to distal pancreatectomy was 95.6 +/- 3.2 mg/dL in the open-duct group, 91.6 +/- 3.0 mg/dL in the ligation group, 94.0 +/- 4.0 mg/dL in the acrylate group, 226.3 +/- 56.6 mg/dL in the neoprene group, and 94.1 +/- 2.6 mg/dL in the Roux-en-Y group. Mean K values (rate constant of glucose clearance) were as follows: open-duct group, -0.907+ +/- 0.240% per minute; ligation group, -1.024% +/- 0.253% per minute; acrylate group, -0.820% +/- 0.087% per minute; neoprene group, -0.526% +/- 0.186% per minute; and Roux-en-Y group, -1.399% +/- 0.566% per minute (normal, -2.201% +/- 0.388% per minute). Insulin release during IVGTT (basal to peak insulin difference) was greatest in the open-duct and Roux-en-Y groups. Although glucose clearance and insulin release were optimal with pancreaticojejunostomy, peripancreatic complications developed in two of the five dogs. In conclusion, the open-duct technique and Roux-en-Y pancreaticojejunostomy result in optimal endocrine function in this in situ model. Due to its simplicity, the open-duct technique is most suitable for further laboratory investigations of segmental pancreatic transplantation.