Radical resection remains the only curative treatment option in pancreatic cancer. Postoperative pancreatic fistulas (POPF) occur in up to 30% of patients leading to prolonged hospital-stay, increased cost of care and morbidity and mortality. Mechanical properties of the pancreas are associated with POPF. The aim of this study is to analyze the role of extracellular matrix (ECM) and tissue mechanics in the risk of POPF.

Biopsies of 41 patients receiving a partial pancreas-resection are analyzed. Clinical data, ECM components and mechanical properties are correlated with POPF.

Preoperative cholestasis is correlated with reduced risk of POPF, which comes along with a dilatation of the pancreatic duct and significantly higher content of collagen I. Patients developing POPF exhibited a degenerated tissue integrity, with significantly lower content of fibronectin and a trend for lower collagen I, III, IV and hyaluronic acid. This correlated with a soft tactile sensation of the surgeon during the intervention. However, this was not reflected with tissue mechanics evaluated by ex vivo uniaxial compression testing, where a significantly higher elastic modulus and no effect on the stress relaxation time were found.

In conclusion, patients with cholestasis seem to have a lower risk for POPF, and an increase in collagen I. A degenerated matrix with lower content of structural ECM components correlates with increased risk of POPF. However, ex vivo uniaxial compression testing failed to clearly explain the link of ECM properties and POPF.

根治性切除仍然是胰腺癌唯一的治愈性治疗选择。高达 30% 的患者会发生术后胰瘘 (POPF)，从而导致住院时间延长、护理成本以及发病率和死亡率增加。胰腺的机械特性与 POPF 相关。本研究的目的是分析细胞外基质 (ECM) 和组织力学在 POPF 风险中的作用。

对接受部分胰腺切除术的 41 名患者的活检进行了分析。临床数据、ECM 成分和机械性能与 POPF 相关。

术前胆汁淤积与 POPF 风险降低相关，后者伴随着胰管扩张和 I 型胶原蛋白含量显着增加。 , III, IV 和透明质酸。这与手术期间外科医生的柔软触感相关。然而，这并没有反映在通过离体单轴压缩测试评估的组织力学中，其中发现弹性模量显着更高并且对应力松弛时间没有影响。

总之，胆汁淤积患者的 POPF 风险似乎较低，并且 I 型胶原蛋白增加。结构 ECM 成分含量较低的退化基质与 POPF 风险增加相关。然而，体外单轴压缩测试未能清楚地解释 ECM 特性与 POPF 的联系。