Premium
Reconstruction of the common bile duct by a vascular prosthetic graft: an experimental study in pigs
Author(s) -
Christensen Margot,
Laursen Henrik Blegvad,
Rokkjær Mogens,
Jensen Peter Funch,
Yasuda Yoshikazu,
Mortensen Frank Viborg
Publication year - 2005
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-005-0976-1
Subject(s) - medicine , laparotomy , cystic duct , cholangiography , surgery , anastomosis , gallbladder , bile duct , fibrin glue , hepatolithiasis , common bile duct , hepatectomy , resection
Background/Purpose The purpose of the present study was to investigate whether it was possible to use a vascular graft for reconstruction of the common bile duct (CBD) in pigs. Methods Eight pigs, each weighing approximately 60 kg, were used for the experiments. The gallbladder was dissected and the cystic duct and cystic artery were ligated and divided. The CBD was displayed and divided. Then the CBD was reconstructed with a standard walled expanded polytetrafluoroethylene (ePTFE) vascular graft (internal diameter 4 mm) by means of 12 interrupted monofilament glycomer 63 (Biosyn) 4.0 sutures. The ends of the vascular graft were inserted into the CBD and the sutures were placed through the graft and the CBD in such a way that the latter would cover the former. The anastomotic line was covered by fibrin glue. On postoperative day 8, a laparotomy was performed; the pigs were investigated for signs of gall leakage, and cholangiography was performed. Blood samples for the determination of liver parameters were taken before the primary surgery and before the explorative laparotomy. Results At evaluations on the eighth postoperative day, all animals except one were without signs of bile leakage. One pig had an encapsulated biloma. Another animal had to be operated on day 6 because of illness, and laparotomy showed a perforated gastric ulcer, but no bile leakage. Cholangiography revealed slight intrahepatic dilatation in all animals. Bilirubin and alkaline phosphatase levels were unaffected by the surgery. Conclusions Reconstruction of the CBD by means of a vascular graft seems to be a safe procedure in the short term in a pig model.