Self-assembling peptide hydrogel SPG-178 effectively prevents postoperative pancreatic fistula compared with polyglycolic acid mesh with fibrin glue in rats

Postoperative pancreatic fistula (POPF) is a common and potentially life-threatening complication after pancreatectomy. Although various methods have attempted to prevent POPF, none have proven to be fully effective. This study used a rat model to compare the efficacy of a self-assembling peptide hydrogel, SPG-178, in preventing POPF with that of polyglycolic acid mesh combined with fibrin glue (PGA + FG). A rat model of POPF was created by pancreatic transection. The rats were randomly assigned to groups in which the pancreatic stump was untreated (control) or treated with SPG-178 or PGA + FG. The groups were compared based on ascitic amylase levels, macroscopic findings at relaparotomy (saponification and adhesion), and histological examination of the resected specimens. Three days after transection, the mean (± standard deviation) ascitic amylase level was significantly lower in the SPG-178 group (109 ± 58 IU/L) than in the control (283 ± 126 IU/L) and PGA + FG (219 ± 128 IU/L) groups ( p < 0.0001). On relaparotomy, saponification around the pancreatic stump and intra-abdominal adhesions were markedly reduced in the SPG-178 group compared with the other groups. Histological analysis also found milder edema, necrosis, hemorrhage, and inflammatory cell infiltration in the SPG-178 group than in the PGA + FG group. SPG-178 demonstrated favorable sealing performance compared with PGA + FG in this rat model. These findings support further preclinical and clinical evaluation of SPG-178 as a novel sealant for preventing postoperative pancreatic fistula.