[Reconstruction of bile duct lesions by an autologous vein graft and a bio-degradable endoluminal stent in an animal model: technique and clinical impact].
BACKGROUND
In this study a new treatment of bile duct lesions was investigated. A segment of the bile duct was replaced by an autologous venous interponate which had been endoluminally stented with a braided bio-degradable stent.


METHODS
A total of 18 pigs (20-28 kg) was divided into three equal groups (I-III). In each group a 2 cm segment of the jugular vein was harvested. The animals in Group I (vein group, n = 6) underwent resection of a 2 cm long segment of the common bile duct which was replaced solely by the venous interponate, in Group II (stent group, n = 6) the venous interponate had been endoluminally stented by a braided bio-degradable stent. Group III (control group, n = 6) underwent only a circular mobilization of the common bile duct. Postoperatively survival rate, general condition as well as the weight were observed and checked for 6 months. During surgery and finally after sacrifice after 6 months blood and tissue samples were taken and semiquantitatively scored concerning grade of inflammation and fibrosis.


RESULTS
In the stent and control group all animals survived in good condition. 3 pigs of the vein group died within 3 weeks showing signs of biliary peritonitis, another one died due to a high grade stenosis of the common bile duct with secondary biliary cirrhosis after 4 months. In the stent group all animals survived until sacrifice after 6 months. On examination the venous interponate was laminated with bile duct epithelium showing the diameter of the implanted stent.


CONCLUSIONS
The reconstruction of bile duct lesions by a venous interponate in combination with a bio-degradable stent is easy to perform and represents a clinically interesting alternative to the biliodigestive anastomosis because of the preservation of the sphincter oddi. After 6 months the stent is completely absorbed and the venous interponate is laminated with bile duct epithelium.
Heistermann
H P
HP
Chirurgische Universitätsklinik der Ruhr-Universität Bochum, Marienhospital Herne. heistermann@st-marien-hospital.de
Palmes
D
D
Hierlemann
H
H
Ebsen
M
M
Horstmann
R
R
Hohlbach
G
G
Spiegel
H U
HU
D020341:Absorbable Implants; D000818:Animals; D001652:Bile Ducts / Q000601:surgery*; D001835:Body Weight; D003135:Common Bile Duct / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015607:Stents; D013552:Swine; D013997:Time Factors; D014182:Transplantation, Autologous; D014680:Veins / Q000637:transplantation*