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Primary closure of choledochotomy using CO 2 laser: Comparison with suture closure
Author(s) -
Vanterpool Clyde C.,
Gales Morris E.,
Bolton Steven,
Hawkins Robert P.
Publication year - 1993
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1900130406
Subject(s) - medicine , surgery , fibrous joint , vicryl , dehiscence , prolene , stenosis , radiology
This study was designed to compare laser welding to suture closure of the common bile duct (CBD). A 12 mm linear choledochotomy was closed in 12 mongrel dogs using tissue welding lowenergy CO 2 laser. Tissue welding was accomplished at 5.0 w/cm 2 for 120 sec. Twelve similar mongrel dogs (control) were treated with CBD closure using 5/0 Vicryl (polyglactin 910, Ethicon, Inc., Somerville, NJ) interrupted simple stitches. All animals were sacrificed at six weeks. Gross and histologic evaluation of the choledochotomy site were performed. There were no statistical differences in parameters of comparison in the two groups. These parameters were pre‐ and post‐treatment measurements of liver function tests, stenosis, and dehiscence. However, it must be noted that there was a 33% (4/12) incidence of dehiscence and death in the CO 2 laser welded choledochorrhaphy. This result, although not statistically significant, is clinically significant. We conclude that the tensile strength of CO 2 laser welded CBDs must be optimized and that these results are preliminary and still unreliable to recommend for clinical adaptability. © 1993 Wiley‐Liss, Inc.