Temporary Replacement of the Common Biliary Duct by a Silicone Tube, as an Urgent Repair of Iatrogenic Injury. Experimental Study in Pigs

Publication date: Available online 11 February 2015 Source:Cirugía Española (English Edition) Author(s): Daniel A. Napolitano , Xavier Rodríguez Bertola , Gabriela M. Sambuelli , Luis H. Vial , Daniel A. Torrecillas Surgery of the biliary tract is complex, and its volume has increased with iatrogenic injuries and living donor transplantation. The aim of this study was to analyze if the common duct can be temporarily replaced. We used nine 18–20kg pigs. They were operated on, and their bile duct was replaced by a 100% silicone tube. All pigs underwent laboratory tests, magnetic resonance imaging, intraoperative ultrasound, cholangiography and biliar manometry with pathological biopsy examination within 60 days from the initial surgery. All pigs survived the first surgery over 60 days without laboratory evidence of evident cholestasis. Nine pigs were re-operated on at day 60 showing dilated common bile duct and hepatic ducts doubling its original size without dilating the intrahepatic bile ducts. There were no clinical, relevant laboratory or biopsy signs showing cholestasis. This experience represents the initial intention to find an optimal situation and prosthesis for replacement of the thin biliary tract, in surgical emergencies or palliative situations. The silicon tube is a positive answer that remains permeable. A non-fibrotic reaction was found that allows a posterior definitive procedure, maintaining a good nutritional status.
Source: Cirugia Espanola - Category: Surgery Source Type: research