[Pedicled small intestine segment for circular replacement of the extrahepatic bile duct in preserved papillary passage. An animal experiment study]

Abstract

The effect of a small bowel segment as a extra-hepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy showed that the grafts had healed without any sign of irritation. Histologically the structure of the graft remained undisturbed. There was a clear distinction between the mucosa of the bile duct and that of the small bowel, with no sign of a chronic infection. In the graft as well as in the vascular pedicle the nerve fibres were intact. Liver biopsy showed no pathological changes. In the light of these experiments, a small bowel segment presents a very promising alternative replacement of the extrahepatic biliary tract.