Repair of bile duct injuries with Gore-Tex vascular grafts: experimental study in dogs.
Bile duct injury is the most feared complication related to biliary tract operations. The goal of this investigation was to offer an alternative treatment that might prevent this complication. Twelve mongrel dogs, thin-walled FEP-ringed Gore-Tex vascular grafts, and Gore-Tex sutures were used in this study. The dogs were randomized into three groups of four according to the length of time of graft implantation: group 1 = 1 month; group 2 = 2 months; and group 3 = 3 months. During the first part of the study, a biliary injury was induced by ligating the middle choledocus after performing a conventional cholecystectomy. During the second part of the study, biliodigestive and biliobiliary anastomosis were performed using Gore-Tex vascular grafts prior to resection of the stenotic area. Initially, an increase in serum bilirubin and alkaline phosphatase levels was noted. Two weeks later, after implantation of the grafts, these values returned to normal. Thin-walled FEP-ringed Gore-Tex vascular grafts were found to be useful in the repair of bile duct injuries, especially in complete transections of the common bile duct. The ductility and flexibility of the material allows any type of anastomosis to be performed, especially when bile duct-gut anastomosis is technically difficult.
Gómez
Néstor A
NA
Department of Surgery, School of Medicine, University of Guayaquil, Guayaquil, Ecuador. ngomez@gye.satnet.net
Alvarez
Ludwig R
LR
Mite
Alfredo
A
Andrade
Jean P
JP
Alvarez
José R
JR
Vargas
Paola E
PE
Tomalá
Nancy E
NE
Vivas
Alex F
AF
Zapatier
Jorge A
JA
D000818:Animals; D001707:Biopsy, Needle; D001807:Blood Vessel Prosthesis; D002758:Cholangiography; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D008297:Male; D011474:Prosthesis Design; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013536:Suture Techniques; D013718:Tensile Strength; D016896:Treatment Outcome