Short intussusception valves prevent reflux after jejunal interposition bilioduodenal anastomosis.
Short whole circumference and semi-circumference intussusception valves were created in interposition cholecysto-jejunal-duodenal conduits in pigs to determine which method best prevented gastrointestinal reflux into the biliary tract. Following intravenous injection of 99 mTc-HIDA the time interval for its excretion from the liver and appearance in the duodenum was not different in either whole or semi-circumference valve animals or in controls without valves. After intragastric administration of 99 mTc-DTPA the relative radioactivity of gallbladder contents (reflux) in the cohort without valves was significantly higher than in both cohorts with valves. Animals with semi-circumferential valves in turn had significantly higher levels of nuclide than those with whole circumference valves. Reflux was observed grossly in 100% of animals without valves, in 20% of those with semi-circumference valves, and in no animals with whole circumference valves. This study indicates that both whole and semi-circumference intussusception valves placed in jejunal biliary conduits allow unimpeded flow of bile into the gastrointestinal tract. Whole circumference valves are more effective for prevention of reflux than semi-circumferential valves.
Liu
X Y
XY
Department of Surgery, First Affiliated Hospital, Hunan Medical College, Changsha.
Liu
S
S
Shen
L R
LR
Pan
A Y
AY
Wen
J F
JF
Zhang
S S
SS
Han
M
M
Stiegmann
G V
GV
D000818:Animals; D001655:Bile Reflux / Q000473:pathology / Q000517:prevention & control*; D002768:Choledochostomy / Q000379:methods*; D007583:Jejunum / Q000473:pathology; D013552:Swine