Reconstruction of the common bile duct by a vascular prosthetic graft: an experimental study in pigs.
OBJECTIVE
The purpose of the present study was to investigate whether it was possible to use a vascular graft for reconstruction of the common bile duct (CBD) in pigs.


METHODS
Eight pigs, each weighing approximately 60 kg, were used for the experiments. The gallbladder was dissected and the cystic duct and cystic artery were ligated and divided. The CBD was displayed and divided. Then the CBD was reconstructed with a standard walled expanded polytetrafluoroethylene (ePTFE) vascular graft (internal diameter 4 mm) by means of 12 interrupted monofilament glycomer 63 (Biosyn) 4.0 sutures. The ends of the vascular graft were inserted into the CBD and the sutures were placed through the graft and the CBD in such a way that the latter would cover the former. The anastomotic line was covered by fibrin glue. On postoperative day 8, a laparotomy was performed; the pigs were investigated for signs of gall leakage, and cholangiography was performed. Blood samples for the determination of liver parameters were taken before the primary surgery and before the explorative laparotomy.


RESULTS
At evaluations on the eighth postoperative day, all animals except one were without signs of bile leakage. One pig had an encapsulated biloma. Another animal had to be operated on day 6 because of illness, and laparotomy showed a perforated gastric ulcer, but no bile leakage. Cholangiography revealed slight intrahepatic dilatation in all animals. Bilirubin and alkaline phosphatase levels were unaffected by the surgery.


CONCLUSIONS
Reconstruction of the CBD by means of a vascular graft seems to be a safe procedure in the short term in a pig model.
Department of Surgery, Kolding Hospital, Denmark Skovvangen 2-8, 6000, Kolding, Denmark.
Margot
M
Christensen
Henrik Blegvad
HB
Laursen
Mogens
M
Rokkjaer
Peter Funch
PF
Jensen
Yoshikazu
Y
Yasuda
Frank Viborg
FV
Mortensen
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D001672:Biocompatible Materials / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis; D003135:Common Bile Duct / Q000293:injuries / Q000601:surgery*; D005260:Female; D023421:Models, Animal; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D013536:Suture Techniques; D013552:Swine
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene