Application of 3D Printing to Design and Manufacture Pancreatic Duct Stent and Animal Experiments

Abstract

Objective: Postoperative pancreatic fistula (POPF) is a common and challenging complication following pancreaticoduodenectomy (PD), occurring in 2% to 46% of cases. Despite various pancreaticojejunostomy techniques, an effective method to prevent POPF has not been established. This study aimed to develop and evaluate a novel 3D-printed biodegradable pancreatic duct stent to simplify the surgical process of pancreaticojejunostomy, reduce anastomotic complexity, and minimize postoperative complications. Methods: Data from 32 patients undergoing total laparoscopic pancreaticoduodenectomy were utilized. Preoperative CT scans were transformed into 3D reconstructions to guide the design and printing of customized stents using polylactic acid (PLA). The stents were assessed for mechanical integrity, surface texture, and thermal stability. Animal experiments were conducted on 16 mini pigs, with the experimental group receiving the novel stent and the control group receiving traditional silicone stents. Results: The 3D-printed stents demonstrated accurate dimensional replication and mechanical reliability. In the animal experiments, the experimental group showed no significant difference in postoperative complications compared to the control group. At 4 weeks post-surgery, CT scans revealed well-healed anastomoses in both groups, with no significant inflammation or other complications. Histological examination and 3D reconstruction models confirmed good healing and device positioning in the experimental group. Conclusion: The 3D-printed biodegradable pancreatic duct stent offers a promising solution for pancreaticojejunostomy, with comparable safety and efficacy to traditional methods. Further research is needed to validate its clinical application.

Keywords: 3D printing; biodegradable stent; pancreaticoduodenectomy; pancreatojejunostomy; postoperative pancreatic fistula.

Figure 1

Traditional silicone internal drainage stent tube.

Figure 2

Three-dimensional reconstruction: (a) 3D modeling of pancreatic duct; (b) dimensional measurement; (c) 3D reconstruction of pancreatic head cancer.

Figure 3

Design of the pancreatic duct stent: (a) design of novel pancreatic duct stent; (b) internal structure of the stent; (c) schematic diagram of the placement of the novel stent; (d) pancreatic duct stent finished product; (e) side view of pancreaticojejunostomy; (f) front view of pancreaticojejunostomy.

Figure 4

Animal experiment pictures: (a) Tibetan miniature pig; (b) pancreatic neck ligation in the first stage of surgery; (c) pancreatic duct stent placement in the second stage of surgery; (d) pancreaticojejunostomy completed in the second stage of surgery; (e) good matching of the stent tube in the second stage of surgery.

Figure 5

Material characterization: (a) tensile strength and strain of novel pancreatic duct stent; (b) XRD of novel pancreatic duct stent; (c) microscopic surface structure (100× and 500×); (d) thermogravimetric analysis.

Figure 6

Immunohistochemical staining of IL-6 and IL-10 expression in anastomotic pancreatic tissue: (a) IL-6 immunohistochemistry of pancreaticojejunal anastomosis tissue in the experimental group, 20 μm; (b) IL-6 immunohistochemistry of pancreaticojejunal anastomosis tissue in the control group, 20 μm; (c) IL-10 immunohistochemistry of pancreaticojejunal anastomosis tissue in the experimental group, 20 μm; (d) IL-10 immunohistochemistry of pancreaticojejunal anastomosis tissue in the control group, 20 μm.

Figure 7

HE staining (20 μm) ((a) experimental group, (b) control group).

Figure 8

The novel stent was visualized in the second-stage postoperative follow-up CT scan. The stent was in a good position and was visualized because barium sulfate was added to the head of the stent tube.

Figure 9

Pancreatic specimens after euthanasia: (a) proximal pancreas; (b) distal pancreatic body and tail and pancreaticojejunostomy; (c) lateral view of the novel stent; (d) front view of the novel stent.