Bile duct replacement using an autologous femoral vein graft: an experimental study. Preliminary results.
The repair of common bile duct injuries is a complex procedure with a significant rate of postoperative morbidity and mortality. The aim of this study was to demonstrate the usefulness of the autologous vein graft in replacement of the bile duct. Twelve male Sprague-Dawley rats weighing 350+/-550 g were used in the study and were divided at random into two groups: the control group (60) and the experimental group in which a 3-mm segment of the bile duct was resected and the biliary tract was replaced by a segment of vein aided by stent (G1). Both groups were subdivided into pairs of rats to study at 30, 60, and 120 days. All of the animals underwent radioisotope cholangiography, a repeat laparotomy, and blood tests for further pathologic study. The clinical evaluation and biochemical nuclear medicine and pathologic studies showed no evidence of cholestasis. The histologic study of the graft showed replacement of the endothelium by biliary-appearing epithelium. The use of an autologous vein graft with a supporting stent proves to be a feasible and alternative procedure for bile duct reconstruction. Further experimental studies should be carried out to validate these findings so they can be implemented in clinical cases.
Capitanich
Pablo
P
Departments of Surgery, Hospital Alemán, C1118ATT Buenos Aires, Argentina. pcapitanich@hospitalaleman.com.ar
Herrera
Javier
J
Iovaldi
Mario L
ML
Balbuena
Roque
R
Casas
Gabriel
G
Malizia
Patricio
P
Bun
Maximiliano
M
Mezzadri
Norberto
N
D000818:Animals; D001707:Biopsy, Needle; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003131:Combined Modality Therapy; D003135:Common Bile Duct / Q000473:pathology* / Q000601:surgery*; D004195:Disease Models, Animal; D005268:Femoral Vein / Q000473:pathology* / Q000637:transplantation*; D006085:Graft Survival; D007150:Immunohistochemistry; D008297:Male; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures / Q000379:methods; D012016:Reference Values; D012680:Sensitivity and Specificity; D015607:Stents; D014182:Transplantation, Autologous; D014656:Vascular Surgical Procedures / Q000379:methods*