Protective Effect of An Amnion Patch Against Postoperative Pancreatic Fistula (Popf) Following Pancreatic Anastomosis in Rats: An in Vivo Experimental Study

Abstract

Postoperative pancreatic fistula (POPF) remains a major complication following pancreatic anastomosis and is associated with substantial postoperative morbidity. The amniotic membrane possesses both barrier properties and biologically active components that may promote tissue healing and preserve anastomotic integrity. This study aimed to evaluate the protective effect of an amnion patch against POPF following pancreatic anastomosis in rats.

This in vivo experimental study used a posttest-only control-group design involving 24 male Sprague–Dawley rats randomized into a control group (K-1; n=12) and an amnion-patch group (K-2; n=12). All animals underwent pancreaticojejunostomy, with additional amnion-patch application in K-2. Outcomes included POPF occurrence, macroscopic anastomotic integrity, intra-abdominal adhesion score, and peritoneal amylase and lipase levels.

Four of 12 animals in K-1 and 11 of 12 in K-2 reached the final evaluation. POPF occurred in 4/4 (100%) K-1 animals and 2/11 (18.2%) K-2 animals (p=0.011). The amnion-patch group demonstrated better macroscopic anastomotic integrity and significantly lower adhesion scores [median 0 (IQR 0–1) vs 1.5 (IQR 1–2); p=0.006]. Peritoneal amylase and lipase levels were also significantly lower in K-2 (p=0.013 and p=0.006, respectively).

Among animals reaching the final evaluation, amnion-patch application was associated with a lower incidence of POPF, reduced intra-abdominal adhesion severity, lower peritoneal pancreatic enzyme levels, and improved macroscopic anastomotic integrity.