title: Canine choledochotomy closure with diode laser-activated fibrinogen solder.
abstract: BACKGROUND
  An alternative to mechanical stapling or hand suturing is needed to permit laparoscopic common bile duct exploration. We evaluated the strength and healing characteristics of canine choledochotomies sealed with a fibrinogen solder and a diode laser.
  
  
  METHODS
  After creation of a 0.5 cm longitudinal choledochotomy, the edges were coapted with forceps, and a fibrinogen solder mixed with indocyanine green dye was applied. The solder was sealed in place with an 810 nm diode laser (125 W/cm2).
  
  
  RESULTS
  Immediate mean leakage pressure was 264 +/- 7 mm Hg compared with 83 +/- 66 mm Hg in suture controls. This increased to 364 +/- 115 mm Hg at 2 days and was more than 510 mm Hg at 7 days. On histologic examination rapid reabsorption of the solder with no signs of inflammation or stenosis was seen. No episodes of dehiscence or peritonitis occurred.
  
  
  CONCLUSIONS
  Laser soldering provides a watertight choledochotomy closure with adequate immediate strength allowing a reliable, technically feasible common bile duct exploration via a laparoscopic approach.
authors.affiliation: Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032.
authors.forename: L S
authors.initials: LS
authors.lastname: Bass
authors.forename: S K
authors.initials: SK
authors.lastname: Libutti
authors.forename: M C
authors.initials: MC
authors.lastname: Oz
authors.forename: J
authors.initials: J
authors.lastname: Rosen
authors.forename: M R
authors.initials: MR
authors.lastname: Williams
authors.forename: R
authors.initials: R
authors.lastname: Nowygrod
authors.forename: M R
authors.initials: MR
authors.lastname: Treat
mesh_terms: D000818:Animals; D003135:Common Bile Duct / Q000601:surgery*; D004285:Dogs; D015718:Fibrin Tissue Adhesive; D007208:Indocyanine Green / Q000627:therapeutic use; D010535:Laparoscopy / Q000379:methods*; D017075:Laser Coagulation; D013536:Suture Techniques
chemical_list: D015718:Fibrin Tissue Adhesive; D007208:Indocyanine Green