[Microsurgical bile duct anastomosis: animal experiment and clinical study].
In 10 Göttingen-minipigs an end-to-end anastomosis of the normal common bile duct was accomplished under the microscope with 11/0 Polygalactin-sutures. Biliary flow was controlled by serum concentration of alkaline phosphatase, by cholangiography and by dynamic hepato-biliary scintigraphy 2 weeks, and 3 and 6 months after the operation. Anastomoses were judged by macroscopic, microscopic and scanning electronmicroscopic examination 6 or 12 months postoperatively. The anastomoses presented no stenosis at all, only a light periductal fibrosis with intact luminal epithelium. Alkaline phosphatases and cholangiography showed a normal pattern, the scintigraphy presented dyskinesia after 2 weeks and normal flow at the later controls. After a microsurgical operation one patient showed a normal anastomosis after 6 months. A biliary anastomosis should be made by microscope in all patients with a long life span and unchanged bile duct wall in spite of the more difficult operation.
D000328:Adult; D000818:Animals; D002763:Cholecystectomy; D003135:Common Bile Duct / Q000601:surgery*; D042882:Gallstones / Q000601:surgery; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D013536:Suture Techniques; D013552:Swine; D013556:Swine, Miniature; D014945:Wound Healing
Die mikrochirurgische Gallengangsanastomose: Tierexperimentelle und klinische Untersuchung.