Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature.
OBJECTIVE
Interposition of a jejunal tube between the common bile duct and duodenum.


METHODS
Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum.


RESULTS
The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct.


CONCLUSIONS
The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.
Crema
Eduardo
E
Experimental Laboratory of Surgery Techniques, Department of Surgery, Federal University of Triângulo Mineiro (UFTM), Minas Gerais, Brazil. cremauftm@mednet.com.br
Trentini
Eliane Anrain
EA
Llanos
Juan Carlos
JC
D000469:Alkaline Phosphatase / Q000097:blood; D000714:Anastomosis, Surgical; D000818:Animals; D001663:Bilirubin / Q000097:blood; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002779:Cholestasis / Q000503:physiopathology*; D003135:Common Bile Duct / Q000293:injuries* / Q000601:surgery*; D004195:Disease Models, Animal; D004285:Dogs; D004386:Duodenum / Q000201:enzymology; D005260:Female; D007049:Iatrogenic Disease; D007583:Jejunum / Q000601:surgery*; D008297:Male
D000469:Alkaline Phosphatase; D001663:Bilirubin